Good cholesterol doesnt always lower heart attack risk

Some people with high levels of ‘good’ high density lipoprotein cholesterol (HDL-C) are at increased risk of coronary heart disease (CHD), contrary to earlier evidence that people with more HDL-C are usually at lower heart disease risk. This finding comes from an international study involving researchers funded by the British Heart Foundation (BHF).

The discovery, published in Science, could move researchers away from potentially ineffective HDL-raising drugs to treat CHD, and lead to the development of new heart disease treatments, helping to reduce their risk of heart attack.

The researchers studied people with a rare genetic mutation in the SCARB1 gene, called the P376L variant, which causes the body to have high levels of ‘good’ HDL-C. High levels of ‘good’ cholesterol are commonly associated with reduced risk for CHD. Challenging this view, the researchers unexpectedly found that people with the rare mutation, who had increased levels of HDL-C, had an 80 per cent increased relative risk of CHD – a figure almost equivalent to the increased risk caused by smoking.

Professor Nilesh Samani, British Heart Foundation Professor of Cardiology at Leicester, said: "HDL cholesterol is often referred to as "good" cholesterol because the level of it in the blood shows an inverse relationship with risk of coronary heart disease and heart attacks, that is the higher the level the lower the risk.. However drugs that have been developed so far to raise the level of HDL-cholesterol in the blood have surprisingly been disappointing in terms of reducing CHD. What this study shows that there is the effect of HDL cholesterol on risk of CHD is more complex than we thought and we need to understand it much better so we can develop new treatments."

You can access the BHF press release here: