Hormonal
Low HDL-C is associated with increased cardiovascular risk independent of LDL-C levels, and therapeutic strategies to raise HDL-C (e.g., niacin, fibrates) may provide benefit, although genetic evidence for HDL-C as a causal factor is less clear than for TRL remnants.
Low HDL ('good cholesterol') is a risk factor, but it is complex. Don't obsess over raising it with supplements. Focus on lifestyle changes (exercise, healthy fats) which naturally improve HDL function. If your HDL is low, discuss with your doctor if adding niacin or fibrates is appropriate, but know that the evidence for these drugs is less clear than for lowering LDL or triglycerides.
Epidemiological, mechanistic, and clinical intervention data are consistent with the view that low HDL-C contributes to elevated cardiovascular risk; genetic evidence is unclear however, potentially reflecting the complexity of HDL metabolism.
Why this rating
Strong epidemiological and clinical trial data, but conflicting genetic data makes the causal certainty lower than for TRLs.
Source
Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management
M. John Chapman et al. · European Heart Journal · 2011
DOI 10.1093/eurheartj/ehr112
More from this paper
- In patients at high cardiovascular risk who have achieved LDL-C goals, elevated triglycerides (≥1.7 mmol/L) and/or low HDL-C (<1.0 mmol/L) remain independent predictors of cardiovascular events, and therapeutic targeting of these markers provides incremental risk reduction.Good
- Elevated triglycerides serve as a marker for increased numbers of triglyceride-rich lipoprotein (TRL) remnants, which are directly atherogenic by penetrating the arterial wall, accumulating in plaques, and promoting inflammation and thrombosis.Good
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