For Some, Low Levels of 'Good' Cholesterol May Not Be Bad
Very Low LDL 'Bad' Cholesterol May Cut Heart Risk Even if HDL 'Good' Cholesterol Is Also Low
Reducing LDL With Statins continued...
In the new analysis, Ridker says, those on placebo with high HDL levels were protected from cardiovascular events, with those in the highest group having about half the risk of cardiovascular events as those in the group with the lowest HDL levels.
But among the patients who took Crestor, no links were seen between their HDL levels and their risk of heart attack or stroke.
Despite the finding, Ridker says the issue must be further studied. Studies of new drugs to boost HDL are under way, he says.
And despite his finding that HDL may not matter in those with very low LDL levels, he emphasizes that "HDL remains an important predictor of risk in the general population." The LDL levels of the JUPITER participants on drug therapy, he says, are very low and not typically achieved in Western populations without intensive drug treatment.
In the study, the median LDL for those on Crestor was 55 mg/dL.
Lifestyle matters, too, he tells WebMD. "If you are at increased risk [of cardiovascular disease] due to increased LDL, a low HDL, or an elevated high sensitivity C-reactive protein [another marker for heart disease], the real message should be to go to the gym, throw out the cigarettes, and lose some weight. Next, talk to your doctor about statin therapy."
The new finding supports what cardiac specialists believe about treatment of heart disease risk factors, says Sidney C. Smith, Jr., MD, professor of medicine and director of the Center of Cardiovascular Science and Medicine at the University of North Carolina, Chapel Hill, who reviewed the findings for WebMD.
"The primary focus of our treatment strategies should be reduction of LDL, and this article certainly supports that,'' says Smith, a past president of the American Heart Association.
However, he had a caveat. "I do not think that the evidence in this study is sufficient to say that addition of therapy focusing on HDL would not help. I think the jury is still out on whether there might be therapies which increase HDL that could have additional benefit."