Normal cholesterol: High HDL levels may not protect the heart

What is a healthy cholesterol level? New study finds high levels of “good cholesterol,” or HDL, may not protect against heart disease, especially for Black adults.

For decades doctors have been telling their patients that high levels of HDL, otherwise known as “good cholesterol,” could protect them from heart disease. But a new study suggests that having a lot of so-called good cholesterol doesn’t mean a lower risk of heart attacks.  

That doesn’t mean HDL levels have no impact.

An analysis of data from nearly 24,000 American adults revealed that too little HDL cholesterol was associated with an increased risk of heart disease — in white adults, but not in Black adults, researchers reported Monday in the Journal of the American College of Cardiology.  

The new findings surprised the researchers, who originally designed their study to understand how cholesterol levels in Black and white middle-aged adults without heart disease affected their future risks. Previous research on "good" cholesterol and heart disease consisted of mostly white adults. 

“I did not expect high levels of HDL would not be protective,” said the study’s senior author, Nathalie Pamir, an associate professor of cardiovascular medicine in the Oregon Health and Science University School of Medicine. “And I certainly did not expect low levels to have no predictive value for Black adults.”

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