Wednesday, December 29, 2010

HDL vs Heart Disease

You can't rely solely on your statin to prevent heart disease.  Just last week, authors analyzed 20 randomized controlled trials including 543,210 person-years of follow up and noted that after accounting for LDL (bad cholesterol), age, blood pressure (hypertension), diabetes, and tobacco use, lower HDL (good cholesterol) was associated with an increase risk of heart attacks, regardless of whether statins were used or not.  

For every 10mg/dL decrease in HDL, there was a 7.1-8.3% increase risk of heart attack in statin users & non-users, respectively, without either threshold or ceiling effect.  In other words, while we've said in the past that normal HDL is >40mg/dL, it turns out that a progressively lower risk of heart attack exists the higher one's HDL, even above 60mg/dL.  Conversely, there's a progressively greater risk for heart attacks w/HDL <60mg/dL.  So the question you need to ask yourself is whether you want to be normal or whether you want to be optimal.  The choice is yours.  

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