Is HDL, known as good cholesterol, really beneficial for everyone? – 11/26/2022

I believe everyone has heard about cholesterol and its two main fractions: LDL (low density cholesterol) and HDL (high density cholesterol). In practice, we call LDL bad cholesterol, as it is related to the occurrence of heart attack, stroke and thrombosis; and we call HDL the good cholesterol, as it exerts a protective effect on our blood vessels, reducing the fatal blockages.

However, there are doubts about the ability of HDL to exert its protective effects in all people, regardless of race. Being more specific and more objective, there are doubts whether the benefits of HDL are similar in the white population and in the black population.

To resolve this issue, researchers at the University of Oregon, in the United States, carried out a comparative study for this purpose. First, the researchers noted that, in the 1970s, when the concept of the protective role of HDL was widely publicized, studies at that time had only been done with white people.

In the current research, they identified that reduced levels of HDL are correlated with an increased risk of heart attack in the white population, with the same scenario not being observed in the black population. Furthermore, elevated HDL levels were not correlated with a reduction in cardiovascular disease in either the white or black population.

On the other hand, the researchers found that high levels of LDL, as well as triglycerides (a type of fat that is present in pasta, sweets and alcoholic beverages), are indicators of greater risk for cardiovascular disease in white and black individuals.

The main protocols and programs for the prevention of cardiovascular disease traditionally consider some population aspects such as age group and race. This planning would not only have a medical nature, but also a financial one, since greater investments are generally directed towards occurrences by age group and by race. This University of Oregon survey included people age 45 and older and clinical follow-up was conducted for approximately 10 years.

Considering then the notes made by this recent research and also the need to optimize investments for the programming of prevention of cardiovascular disease, we may be facing an important paradigm shift.

In clinical practice, we may be starting a phase in which high levels of HDL would no longer be an isolated and global factor for cardiovascular safety and, on the other hand, high levels of LDL could be acquiring a greater level of importance than has already been assumed. imagined.

We can also add that analyzing high LDL levels in conjunction with markers, such as triglyceride levels, could compose a more reliable protocol to measure cardiovascular risk and to optimize the best preventive measures.

To end this discussion, I would like to leave here my opinion, as a professional that I am in the field of cardiology and cardiovascular surgery. We have to respect this new trend, but continue to monitor new research that is in progress.

The central question is really to identify the factors that most promote cardiovascular risk and, based on the results of this research carried out by the University of Oregon, everything is heading towards greater attention to LDL levels.