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“Good” Cholesterol May Not Accurately Predict Heart Disease Risk

New research funded by the National Institutes of Health suggests that HDL cholesterol, which is often called the “good” cholesterol, may not be as good at predicting the risk of heart disease and protecting against it as was thought in the past.

In the 1970s, a study found that high levels of HDL cholesterol were linked to a low risk of coronary heart disease. This link has since been widely accepted and is used to measure the risk of heart disease. However, that study only looked at White Americans.

Now, research that came out Monday in the Journal of the American College of Cardiology found that having low levels of HDL cholesterol made White adults more likely to have a heart attack, but it didn’t make Black adults more likely to have a heart attack. Also, neither group was found to be less likely to get heart disease if they had more HDL cholesterol.

“It is well known that low HDL cholesterol levels are bad for everyone, no matter what race they are. In a news release, Nathalie Pamir, the study’s lead author and an associate professor of medicine at the Knight Cardiovascular Institute at Oregon Health & Science University in Portland, said, “Our research put these ideas to the test.”

“It could mean that in the future, our doctors won’t give us a pat on the back when our HDL cholesterol levels are high.”

The researchers used information from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) cohort, which included thousands of people. When people signed up for the program between 2003 and 2007, they had to be at least 45 years old. Their health was tracked for an average of 10 years.

The researchers found that both Black and White adults with high levels of low-density lipoprotein (LDL) cholesterol and triglycerides were more likely to get heart disease.

But they say that more work is needed to figure out why the link between HDL and heart disease risk is different for different races.

In the meantime, they wrote, current clinical assessments of heart disease risk “may misclassify risk in Black adults, which could make it harder for this group to get the best programs for preventing and treating heart disease.”

Dr. Tara Narula, a CNN medical correspondent and associate director of the Lenox Hill Women’s Heart Program, said that the study shows how important it is to do more research on race and ethnicity and that there is no one-size-fits-all solution.

This research also shows how important it is to keep telling people that high levels of HDL are not a free pass and that the focus should be on controlling high levels of LDL and other known signs of increased cardiovascular risk.

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