Good versus bad cholesterol is the wrong way to look at heart health

Main Category: Cholesterol
Article Date: 02 Apr 2004 - 0:00 PDT


We have all known that there is bad cholesterol and good cholesterol. The cholesterol we need is produced by the liver. There is Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). We have always been told that LDL is the bad one, because any excess builds up. We have also been told that HDL is the good one, because it collects the unused cholesterol and takes it back to the liver, where it is destroyed.

If the LDL reaches a point in our bodies at which the HDL can not keep up with the removal we then start having problems. The excess cholesterol starts to cling to the inside of our arteries and blood flow goes down, there could be blockages and heart attacks or strokes. Hence, we are all told that HDL is the important one to have.

Daniel Rader, however, is now saying that this may be the wrong approach. He is a cholesterol researcher at Pennsylvania University School of Medicine. He accepts that HDL is good. He says that if you have a high level of HDL your heart attack and stroke risks will be generally lower.

However, what about a patient whose levels of good and bad cholesterol are both high? Doctors see many people like this. Generally, because the level of good is thought to balance out the other many doctors do not prescribe anything, for example, statins.

According to Dr. Rader, the high level of HDL may not be enough.

He says that the current treatment of waiting till the LDL of a patient goes below the one-hundred level and then stopping the medication could be wrong. He suggests keeping the cholesterol lowering drugs going till the LDL is at a much lower level.

Dr. Rader has found that if you attack the cholesterol levels aggressively you lower the risks of heart attack and stroke more still.

You can read about this in the New England Journal of Medicine, in a study called Prove-It.

Many factors can increase your chances of having a heart attack:

-- Smoking
-- Overweight
-- Inactivity
-- Genetics
-- Age
-- Malnutrition
-- Severe illness

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