The study suggests that HDL, or “good” cholesterol, is less beneficial than previously thought, especially for black adults


High-density lipoprotein, or HDL cholesterol — often referred to as the “good” cholesterol — may not be as useful in predicting risk for and protecting against heart disease as previously thought, according to new research funded by the National Institutes of Health.

A study from the 1970s found that higher levels of high-density lipoprotein (HDL) cholesterol concentration were associated with a lower risk of coronary heart disease, a link that has been widely accepted and used in heart disease risk assessments. However, only white Americans were included in that study.

Now, research published Monday in the Journal of the American College of Cardiology found that lower levels of high-density lipoprotein (HDL) cholesterol were associated with an increased risk of heart attack among white adults, but the same wasn’t true among black adults. Also, high levels of HDL cholesterol were not found to reduce the risk of cardiovascular disease for either group.

“It is well accepted that low levels of HDL cholesterol are harmful, regardless of race. Our research tested these assumptions,” said Natalie Pamir, senior study author and assistant clinical professor of medicine in the Knight Heart and Vascular Institute at Oregon Health & Science University in Portland, in a news release. “It could mean that in the future, we won’t be tabooed by our doctors for having high levels of HDL cholesterol.”

The researchers used data from thousands of people who were enrolled in the Causes of Geographical and Racial Differences in Stroke (REGARDS) group. The participants were at least 45 years old when they enrolled in the program between 2003 and 2007, and their health was analyzed over an average of 10 years.

The researchers found that elevated levels of low-density lipoprotein (LDL) cholesterol and triglycerides were “modest” predictors of heart disease risk among both black and white adults.

But they suggest that more work is needed to understand the reasons for the ethnic differences in the association between HDL and heart disease risk.

Meanwhile, current clinical assessments of heart disease risk “may stratify risk in black adults, which may hinder optimal cardiovascular disease prevention and management programs for this group,” they write.

CNN medical correspondent Dr. Tara Narula, associate director of the Lenox Hill Women’s Heart Program, said the study “highlights the very important need for more research specific to race and ethnicity, and that there is no one-size-fits-all approach… In addition, this research underscores The continued need for education that high levels of HDL are not free and focus should be placed on controlling elevated LDL and other known markers of increased cardiovascular risk.”

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