During Menopause, ‘Good’ Cholesterol May Lose Protective Effect on Heart

HDL cholesterol is commonly called the “good” cholesterol, but new research suggests that it could be harmful to women going through menopause.

The new study finds that rather than helping to inhibit the formation of dangerous plaque in the arteries, HDL cholesterol may increase its buildup during menopause. This process is known as hardening of the arteries, or atherosclerosis, and can lead to heart trouble.

“This was surprising,” said lead researcher Samar El Khoudary, an assistant professor of epidemiology at the University of Pittsburgh.

“We know that the good cholesterol is supposed to protect women,” she said. And, before menopause, good cholesterol does help protect against heart disease, El Khoudary said.

But during menopause, HDL cholesterol seems to add to the plaque buildup. She explained. “This was independent of other factors such as body weight and levels of bad cholesterol,” El Khoudary said.

It’s not clear why good cholesterol may turn bad, she said. “There are many biological changes that happen to women during the menopausal transition,” she said.

Among these changes is the addition of fat to the abdomen and around the heart. “This could put women in a state of chronic inflammation that could change the good cholesterol,” El Khoudary suggested.



Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said the “relationship between HDL cholesterol levels, HDL function, and atherosclerosis progression is complex.”

In certain circumstances, HDL can be inflammatory and increase hardening of the arteries, Fonarow said. “In other words, prior studies have shown that in certain patients or in certain circumstances, the good cholesterol can turn bad and actually promote the atherosclerosis,” he said.

My Take:
There is no such thing as “good” or “bad” cholesterol. Cholesterol is a pawn in the game of atherosclerosis. Over half of patients suffering their first heart attack have normal or even low cholesterol. Statin drugs work (a little bit) because they reduce inflammation, not because they lower cholesterol. And there are much better ways to lower inflammation.

What’s unfortunate is that a vast majority of patients are treated with statin drugs without even measuring these inflammatory factors. Cholesterol levels are then monitored and used as a gauge of success. Effective treatment using drugs or natural methods should be based on markers of inflammation, not how much the LDL and total cholesterol have been reduced.

The Bottom Line:
Forget the total cholesterol, LDL or HDL levels. Look at the high sensitivity CRP (C-reactive protein), fibrinogen, and even the SED rate. If you must evaluate serum lipids, look at the L(p)a. It does correlate well with the risk of heart attack. However, since no drugs have been developed that alter this test, the medical field has shown little interest in running it. Both niacin and gingko leaf have reduced L(p)a levels significantly in numerous clinical studies. And nattokinase lowers the CRP dramatically with no side effects.

Source: October 16, 2015 National Institutes of Health