Harvard Health Letter

In Brief: Cholesterol: Beyond good and bad, there's big

In Brief

Cholesterol: Beyond good and bad, there's big

Lipoprotein particles are the packages that carry cholesterol through the bloodstream. Low-density lipoprotein particles (LDLs) are considered "bad" because they let cholesterol sit and fester in arteries, allowing atherosclerotic plaque to pile up, which can lead to heart attack and stroke.

But LDLs come in various sizes, and the smallest seem to have the worst health effects. Their size lets them burrow into arterial walls, triggering the atherosclerotic process.

"Good" high-density lipoprotein particles (HDLs) also come in different sizes, and the bigger ones seem to be better at carting cholesterol back to the liver for disposal than the smaller ones. HDLs may have other healthful effects (anti-inflammatory, antioxidant, etc.) that size augments.

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