In a study from Oregon Health & Science University, scientists found that high-density lipoprotein (HDL) cholesterol, often called the “good cholesterol,” may not be as effective as scientists once believed in uniformly predicting heart disease risk among adults of different racial and ethnic backgrounds.
The research found that while low levels of HDL cholesterol predicted an increased risk of heart attacks or related deaths for white adults, a long-accepted association, the same was not true for Black adults.
Additionally, higher HDL cholesterol levels were not linked to reduced heart disease risk for either group.
In the study, the team reviewed data from 23,901 United States adults who participated in the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS).
For the current study, researchers were able to look at how cholesterol levels from Black and white middle-aged adults without heart disease who lived throughout the country overlapped with future heart disease events.
Study participants enrolled in REGARDS between 2003 and 2007, and researchers analyzed information collected throughout a 10- to 11-year period.
During this time, 664 Black adults and 951 white adults experienced a heart attack or heart attack-related death.
Adults with increased levels of LDL cholesterol and triglycerides had modestly increased risks for cardiovascular disease, which aligned with findings from previous research.
However, the study is the first to find that lower HDL cholesterol levels only predicted increased heart disease risk for white adults.
It also expands on findings from other studies showing that high HDL cholesterol levels are not always associated with reduced heart events.
The findings suggest that higher than optimal amounts of “good” cholesterol may not provide heart benefits for either group.
The team says HDL cholesterol has long been an enigmatic risk factor for cardiovascular disease.
The findings suggest that a deeper dive into the epidemiology of lipid metabolism is warranted, especially in terms of how race may modify these links.
The findings suggest that heart disease risk calculators using HDL cholesterol could lead to inaccurate predictions for Black adults.
If you care about heart health, please read studies about the best time to take vitamins to prevent heart disease, and calcium supplements could harm your heart health.
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The study was conducted by Neil A. Zakai et al and published in the Journal of the American College of Cardiology.
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