Cholesterol Archive

New research questions the benefit of drugs to raise HDL, but lifestyle steps to boost good cholesterol are still recommended.

One of the fundamentals of heart-healthy living is that if your LDL (bad) cholesterol is high, you need to take steps to lower it. After all, bad cholesterol contributes to artery-clogging plaque deposits. On the flip side, doctors encourage us to also raise our HDL (good) cholesterol. That's because people with high HDL tend to be at lower risk of heart disease.

Q. I am a 62-year-old female with no chronic health problems, but I am about 10 pounds overweight. My new doctor wants to put me on a statin immediately. My total cholesterol is 187: my LDL is 129, my HDL is 47, and my triglycerides are 55. He is concerned because my father died of a heart attack from coronary artery disease. The doctor wants my HDL to be above 60 and my LDL to be below 100. Could this result be achieved by weight loss, dietary changes, and exercise alone? If not, which statin would you recommend?

A. It's wonderful that you and your physician are giving thoughtful attention to your risk for heart disease. As you probably know, your LDL and HDL numbers are not really ominous. I assume from the absence of any mention of high blood pressure, diabetes, or cigarette smoking that you do not have these other risk factors for heart disease. Thus, the real question is whether your family history of heart disease suggests a genetic tendency to atherosclerosis, despite your fairly reassuring risk factor profile.

Q. How do "cholesterol-lowering" cereals like oatmeal reduce LDL cholesterol? How much do I need to eat to make a difference?

A. Fruits, vegetables, and whole grains are part of a heart healthy diet. Part of the benefit of eating these foods is that they crowd out the high fat and processed foods associated with heart disease and some cancers. These healthful foods are also rich in fiber.

This lipid plays a bigger part than you realize.

The strongest predictors of a woman's stroke risk may be the most over-looked lipids in your cholesterol profile, according to a new study published online Feb. 2, 2012, in the journal Stroke.

The hallmark of atherosclerosis is the accumulation of fatty plaques inside the arteries. Have you ever wondered why this happens? Researchers at NYU Langone Medical Center have an explanation.

The immune system orders cells called macrophages to clean up fat and cholesterol. When macrophages fill up with unhealthy cholesterol, they secrete a protein called netrin-1. As the researchers explained in the January 8, 2012, issue of Nature Immunology, this protein signals the macrophages to stop scavenging and stay put. Instead of transporting cholesterol out of the blood vessel, the macrophages settle into the artery walls, where they become part of the fatty plaques. Such plaques are prone to rupture and cause a heart attack.

What you need to know about these cholesterol-lowering medicines.

If you've been having trouble controlling your cholesterol levels, your doctor may have recommended that you take a statin drug. Statins lower LDL cholesterol—the so-called "unhealthy" or "bad" cholesterol because it helps to form the artery-clogging plaques that can lead to heart disease.

Most people taking statins are accustomed to having routine blood tests to watch for uncommon but serious liver-related side effects. But the rare cases of liver damage from statins aren't accurately predicted by routine blood testing. So, in March, the FDA recommended blood tests for liver function only when a person first starts taking a statin or if symptoms arise.

At the same time, the FDA strengthened label warnings on statins for two other possible side effects: increased blood sugar and temporary memory or cognitive lapses. The blood sugar concerns are supported by study data, while hard data on memory effects are still being collected. The risk of side effects seems to rise with increasing statin dose, and side effects usually stop when the drug is discontinued.

Clogged gut arteries can cause pain—and much worse.

The heart's arteries are common hiding places for cholesterol-filled plaque and blood clots. Plaque can limit blood flow during exercise or stress, causing the chest pain or pressure known as angina. Clots can completely block blood flow, causing a heart attack or cardiac arrest. These two perpetrators can do similar things elsewhere in the body. When they interfere with blood flow to the digestive system, the effects can range from a stomachache after every meal to a life threatening emergency.

What should you eat if you don't like poultry, fish, or beans — the often-cited heart-healthy sources of protein? One study showed that a diet including daily portions of lean beef can lower LDL cholesterol — as long as the rest of the menu includes fruits, vegetables, and whole grains.

Researchers gave 36 healthy men and women with elevated LDL cholesterol levels four different diets for five weeks each. All meals and snacks were prepared by the researchers and consumed either at the study center or at home.

Q. I am 70 years old, and since I started taking testosterone to boost below-normal levels of that hormone, my LDL and HDL levels have dropped. What's the cholesterol–testosterone connection?

A. Testosterone is a hormone that promotes sex drive in both sexes and sperm production in men. It also supports the growth and strength of muscle and bone. There is some scientific evidence to suggest that low testosterone levels contribute to cardiovascular disease, and there is ample evidence that as testosterone levels rise, cholesterol levels fall. So the drop in your LDL and HDL levels makes sense.