HDL is complicated

[Eddy Edson]

https://www.healio.com/endocrinolog...hibits-shortcomings-as-indicator-of-cv-health

A study of the relationship between HDL cholesterol levels and risk for myocardial infarction and death revealed limitations in using HDL-C level as an indicator of health. Although HDL-C has been characterized as “good” cholesterol, the optimal levels are more complicated than has been assumed, according to Marc Allard-Ratick, MD, a hospitalist at Emory University School of Medicine.

IAllard-Ratick and colleagues analyzed data from 5,965 adults, most of whom had heart disease, as part of the Emory Cardiovascular Biobank. The average age of participants was 63 years, and 35% were women.

Researchers found that risks for all-cause mortality, CV mortality and nonfatal MI were elevated among participants with HDL-C levels lower than 30 mg/dL and also among patients with levels above 60 mg/dL. Patients with the lowest risk had “normal” HDL-C levels between 40 mg/dL and 60 mg/dL, Allard-Ratick told Endocrine Today.

....

Underberg said our current understanding of HDL and HDL-C does not yet have implications for individual patients. He suggested technology could lead to an HDL index tool providing a composite view of its many facets, but “for an individual right now, we just do not know.”

Allard-Ratick agreed that the findings should not change patient management practices. For the time being, he said LDL-C remains a much better marker for CV risk, as the use of medication to lower LDL-C leads to a reduction in CV events.

“At this time, the association between very high HDL-C and adverse outcomes is just a correlation, and there is no evidence that lowering HDL-C in these patients leads to improved outcomes,” he said. “Until we have this type of evidence, our management of these patients should be like all others at risk for cardiovascular disease and should focus on improving other modifiable risk factors, such as high blood pressure, high LDL-C, diabetes, obesity and smoking.”

Nothing very clear at the moment, but also not much comfort for those looking to downplay LDL as the most important risk factor. I think a new thing is finding of heightened risk from HDL levels as low as 60 mg/dL.

 

[mikeyB]

Well, they do say they don’t know how this applies to individual patients, and they also say carry on as we are doing. In this game, you can only deal in generalities. This group all had heart disease already, so not a good example of general interest.

 

[Drummer]

I don't worry much about cholesterol and associated bumph, but I chuckled at the report I found of investigation into the population demographic of a Japanese island where the unusually high number of people over 100 years of age were those who were non vegetarian with above average cholesterol.
As I come from a family generally long lived and in good health for decades and who have had fewer tragedies than many, I consider myself born fortunate - but no one ever did tests on us investigating any genetic or physical reason for our collective tranquillity. One reason for my hope of remaining unmedicated is to allow whatever it is that carries individuals into their eighth and ninth decades hale and hearty to have full influence on me as well as previous generations.
There is type two diabetes on both sides of my immediate family - but it was only mismanagement which brought about an early death for my grandmother. All the others are either in good condition of lived into old age fit and well.

 

[Deleted member 21371]

I don't worry much about cholesterol and associated bumph, but I chuckled at the report I found of investigation into the population demographic of a Japanese island where the unusually high number of people over 100 years of age were those who were non vegetarian with above average cholesterol.
As I come from a family generally long lived and in good health for decades and who have had fewer tragedies than many, I consider myself born fortunate - but no one ever did tests on us investigating any genetic or physical reason for our collective tranquillity. One reason for my hope of remaining unmedicated is to allow whatever it is that carries individuals into their eighth and ninth decades hale and hearty to have full influence on me as well as previous generations.
There is type two diabetes on both sides of my immediate family - but it was only mismanagement which brought about an early death for my grandmother. All the others are either in good condition of lived into old age fit and well.

Stay active, still get a lot of exercise from fishing, and eat a diet of rice and fish, you'll live forever.

 

[trophywench]

Exactly that - plus obviously, remain inscrutable at all times, never breath in polluted air and never have ANY mental stress.

Easy peasy for every single one of us including the fact that every single person we ever meet automatically is extremely polite and gives us respect which gets greater as we age.