Is HDL Cholesterol "GOOD" or NOT? - Dr. Anastasia Chopelas

Genetic factors affect HDL cholesterolJust last week, in the Lancet, premier medical journal, an article came out causing a flurry of articles in newspapers asking “Is HDL cholesterol “good” or not?”  I found articles from the NY Times down to some smaller papers calling into question the role of HDL in protecting our heart and circulatory system.

These data challenge the concept that raising of plasma HDL cholesterol will uniformly translate into reductions in risk of myocardial infarction.  Lancet Article

In reading through the results myself, this was a statistical analysis of 20 different studies, including 20913 cases with heart attacks and 95407 cases without.  They were specifically looking at the effect of a gene, specifically the LIPG Asn396er, which genetically predisposes the bearer of that gene to a higher than average HDL level in the bloodstream.

The extra HDL cholesterol in those genetically gifted indivuduals should have reduced the risk of cardiac events by an average of 13%, but in this sampling, it did NOT.   Higher HDL from other observational studies WAS associated with reduced risk of cardiac events.  It seems that before jumping the gun and declaring it a problem, as this article has and all the newspaper articles, such as

An important question is whether things that increase HDL cholesterol levels during our lifetime (i.e. after our genetics are determined), such as exercise and certain medications, can then improve our heart disease risk.  Gazette

Come on, really?  Exercise doesn’t help improve heart disease risk?  Is that reporter serious?

Let’s get to the meat of this:  It means that genetic factors that raise HDL cholesterol doesn’t improve your odds if you are destroying your health by other means.  They state clearly that LDL counts.  What I would like to know is if genetic factors that raise LDL slightly also doesn’t change things.

It seems that we still don’t know a whole lot about the genetic effect of each of the cholesterols on heart disease and that a healthy lifestyle will prevent problems.  I doubt that raising or lowering good and bad cholesterols, respectively, artificially actually improves quality of life or extends life.  There may be fewer heart incidents, but the rates of other problems do seem to go up.  This has been reported by several studies and authors.

The things that I’ve seen shorten lifespans very quickly: drug abuse, smoking, excessive drinking, obesity, lack of exercise.  Bad eating, given that all the rest is okay, is far less of a problem, you can live longer on it, but the quality of life will be poorer.  I’ve seen people die of old age in their 40’s, and mainly due to those factors.

Don’t be lulled into thinking that it doesn’t matter that HDL colesterol is high or not, IT DOES.  It’s just that the genetically “gifted” don’t get that edge.  The rest needs to be proven.