Among the blood fats there is the dreaded “bad” cholesterol, which can promote various cardiovascular diseases at elevated levels. In addition, the “good” cholesterol should be able to counteract the health risk to a certain extent. At least that’s the current state of science – and that’s exactly what US researchers are now denouncing on the basis of a study. Read more regarding this at FITBOOK.
HDL, LDL and triglycerides – all parameters that even laypeople may have heard of in connection with cholesterol levels. Many of them may have already been reassured by a doctor if one of the values mentioned – the supposedly harmless HDL – was increased in their blood count. A US research team now wants to put an end to the times of appeasement. Because their study showed that the “good” cholesterol may not even exist.
Researchers question the existence of “good” cholesterol
In a joint investigation, researchers from various faculties have therefore got to the bottom of the question of how HDL is supposed to have a (positive) effect on cardiovascular health. The study, co-funded by the National Heart, Lung, and Blood Institute (NHLBI), was recently published in the specialist press.1
Explanation of the study basis
It’s usually explained like this. That “bad” lipoprotein LDL transports the fatty natural substance cholesterol from the Leber into various tissues, which can lead to fatty deposits in the blood vessels (and corresponding secondary diseases). The supposedly “good” HDL transports just that cholesterol back. It cause it over the Galle can be eliminated from the body. HDL values that are too low are therefore viewed critically in medicine in the same way as LDL that are too high, while a plus in HDL is considered favorable. “Our study has verified this assumption,” explains study author Nathalie Pamir in a press release.2
The team also focused on any differences between people of different skin colors. In earlier studies, from around the 1970s, a majority of white subjects were used. It was now Pamir’s task to check the general validity of the findings at that time.
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course of the study
Researchers analyzed around 24,000 pieces of data from the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS). This is a longitudinal health information study of a cross-section of the US population, focusing on overall stroke risk and predisposing factors.
For their study, Pamir and her team selected young adult subjects with similar health histories, all of whom had enrolled in REGARDS between 2003 and 2007. They focused on how the documented cholesterol levels had affected the cardiovascular health of the subjects. At the beginning of the data collection, none of them had suffered from cardiovascular disease.
observations
Over the course of 11 years, 664 of the Black and 951 of the White subjects suffered a heart attack, some of them fatally. What they all had in common: increased LDL and triglyceride levels, which indicate an increased risk of disease.
More surprising, however, was the inconsistent presentation of the HDL values. A low HDL value might only be determined in the white subjects of the study and an increased risk of disease might be derived from this. The researchers concluded that, at least in Black adults, a higher HDL level does not mean the all-clear regarding the risk of cardiovascular events.
Changed “risk prediction algorithm” required
The head of research sees the results as being of enormous importance for medical practice. She hopes for a changed “risk prediction algorithm” – doctors should not automatically give patients with high HDL levels favorable prognoses. Especially since earlier studies are said to have pointed out that higher HDL cholesterol levels in whites do not automatically indicate a reduced risk of disease.
That’s why Pamir is certain: other, more generally valid parameters must be used to objectively determine the risk of disease.
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Many questions still unanswered
A lot is still unanswered. In another part of the study, the researchers went into more detail regarding the properties of HDL cholesterol using the microscope. The cooperation with various proteins, which are said to play a role in the onward transport of cholesterol, was also examined – without meaningful findings. “The results suggest that a deeper dive into the epidemiology of lipid metabolism is needed,” said Sean Coad, chief of epidemiology at the NHLBI.