Would raising good cholesterol levels be better at preventing heart attacks and strokes rather than just lowering bad cholesterol levels in when treating patients? In other words, wouldn’t it be better to do both – raise the good and bring down the bad? This question may be answered by researchers who have set up a large international trial.

There are two types of cholesterols:

The Good One – High density Lipoproteins (HDL)
This removes fat from circulation and protects you from heart disease.

The Bad One – Low Density Lipoproteins (LDL)
Excess LDL can build up in the inner walls of arteries, clogging them up.

Researchers are going to treat participants by hitting both LDL, lowering it by giving the patients cholesterol lowering drugs – statins, while at the same time trying to raise their levels of HDL by giving them a drug called niacin. Niacin also lowers triglyceride levels. The niacin is given in combination with another medication to reduce the unpleasant side-effect of flushing (flashing) which occurs after long-term use.

The trial involves 20,000 volunteers and is lead by scientists from Oxford University, England. The participants are aged 50-80 and have a history of heart attack, cardiovascular diseases and/or stroke.

Participants are from the UK, China and Scandinavia. This Oxford team is the same one that carried out a study which showed the benefits of statins, which lower LDL levels and reduce heart attack and stroke risks – it was called the Heart Protection Study, a landmark study.

For patients who currently have vascular disease, raising HDL may benefit them more. People with vascular diseases do not benefit so much from statins.

The researchers are interested in seeing how raising HDL may help people considered to be at high risk of future heart and stroke problems. If it results in significant benefits for these people, most likely the benefits for others will be important as well.

Even though niacin raises HDL, it also lowers triglyceride levels – so it will be hard to know exactly why heart attack and stroke protection exists. Would it be the result of raising HDL only, lowering triglyceride levels only, or a combination?

Written by: Christian Nordqvist
Editor: Medical News Today