Wednesday, January 9, 2013

Clinical Note:  How “Good” Is “Good Cholesterol
Lipitor, now generic, reduced the risk of heart attacked by one-third. Doctors and researchers hoped boosting HDL would go a long way towards limiting remaining risk.
Christopher Weaver, “New Rules for Giving Good Cholesterol a Boost, “ Wall Street Journal, November 7, 2013
January 9, 2013 -   As every student of cholesterol metabolism knows,  elevated HDL,  known as “good cholesterol”, protects against coronary artery disease.
Yet, nearly four years ago,  I suffered a health attack even though  I had these immaculate  lipid values, including an unusually high HDL* for a male.
·         Total cholesterol, 148

·         LDL cholesterol, 57

·         HDL cholesterol,  65*

·         Triglycerides, 140
Theoretically,  or at least so I thought,  my HDL immunized me against a heart attack.   I took great solace in my HDL value, the so-called “good cholesterol.“  I even bragged to friends I had the HDL of a teen-age girl.

I was wrong about HDL protecting me against coronary artery disease. 
And as it turns out,  raising the HDL with drugs would not have  helped prevent a heart attack even though  “bad cholesterol,” was as low as mine was. 
My “natural HDL ”  was high, not because of drugs but because of my inherent metabolism and my life style.  I thought of taking niacin to push my HDL even higher.
As it turns out, “medically elevated HDL,” HDL increases induced by drugs like niacin,  may not be as effective as natural HDL at whisking bad cholesterol away from artery walls.”
According to studies at John Hopkins and Mayo,  these are the “natural” ways of elevating your HDL.
·         Exercising , 4 mg elevation  (I walk the dog five times a day  and stroll the aisles of big box stores)

·         Drinking a little alcohol, 2-4 mg elevation ( I drink one glass of wine each day) 

·         Quitting smoking , 5 mg boost ( I don’t smoke)

·         Losing weight, 1 mg boost every 3 to 6 pounds lost (I lost 20 pounds last year).

·         Eating fish and consuming olive oil, 3 to 5 mg boost ( I eat fish once a week and am an olive oil fan)

·         Avoiding carbohydrates, 8 mg boost  (I’ll have to go lighter on these and heavier on the fruits and vegetables.)

·         I take statins and have a normal blood pressure.
I am being a reasonably good boy and have reasonable good vital signs , but I could do better.  I am hoping my life style keeps my “good” cholesterol high enough to prevent further coronary sclerosis.  I still believe in the “good” cholesterol hypothesis. But you never tell how protective HDL will be.

Tweet:  Proven  ways to raise your "good cholesterol, " HDL, are exercise, alcohol, nonsmaoking weight loss,  fish, olive oil, and minimal carbs.

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