Wisdom Wednesday: ‘Good’ Cholesterol Might Actually Be Bad

A new study published in the European Heart Journal finds that “good” cholesterol, or high-density lipoprotein (HDL) cholesterol, may raise the risk of premature death.

By and large, the medical community suggest that higher levels of the good kind of cholesterol are desirable, as it may protect against heart disease and stroke. By contrast, it is the “bad” cholesterol, or low-density lipoprotein (LDL), that blocks the arteries.

The new research challenges this belief – at least in part. As the authors note, this is the first time that as study has drawn a connection between high HDL cholesterol levels and excessive mortality in the general population.

The study was carried out by researchers from the University of Copenhagen in Denmark. Prof. Borge Nordestgaard, of the university’s Department of Clinical Medicine, is the corresponding author of the study, and Christian M. Madsen, of the university’s Department of Clinical Biochemistry, is the paper’s first author.

Madsen and colleagues combined data from the Copenhagen City Heart Study, the Copenhagen General Population Study, and the Danish Civil Registration System. In total, they examined data on more than 116,000 people and clinically followed them for an average period of 6 years, during which time more than 10,500 people died.

Blood tests for both types of cholesterol levels were taken non-fasting, and statistically, the researchers adjusted for all known variables that are normally associated with all-cause mortality. Such factors included age, body mass index (BMI), smoking – both current and cumulative – alcohol consumption, physical activity, and diabetes.

The study found that men with extreme levels of HDL in their blood had a 106% higher chance of dying prematurely than men with normal levels of this type of cholesterol. Women with extremely high levels of HDL cholesterol were 68% more likely to die prematurely than women with normal levels.



Additionally, the mortality rate in men with “very high” levels of the supposedly good kind of cholesterol also had a 36% higher mortality rate than men with normal levels. The lowest mortality rate was found in those with medium levels of HDL.

Prof. Nordestgaard spoke to Medical News Today about the significance of the findings, saying, “Until now everybody has believed that the higher the HDL cholesterol the better.” But we now show that individuals with extremely high HDL cholesterol have a higher mortality rate than those with average levels. People and doctors should stop thinking that HDL cholesterol is ‘good’ cholesterol and that it may be advantageous to raise HDL cholesterol.”

My Take:
There is no such thing and ‘good’ or ‘bad’ cholesterol. All animals, including us, need cholesterol to manufacture hormones. Seventy-five percent of the cholesterol in your body is made in the liver, the remaining 25% comes from the diet. Cholesterol leaves the liver in the form of LDL as a response to inflammation. Cells throughout the body absorb the LDL and convert it to HDL. Most of the HDL remains within the cell, but some is released back into the blood stream. It then returns to the liver to be recycled as LDL.

The Bottom Line:
There is little or no value in manipulating LDL or HDL levels in the blood. However, if you reduce the cause(s) of inflammation in the body, the LDL and HDL levels will return to healthy norms. This is why fish oil reduces serum lipids in some but not others. The omega-3 fatty acids are anti-inflammatory for prostaglandin inflammation, the most common form of inflammation.

Source: August 24, 2017 Medical News Today