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High Level of 'Good' Cholesterol Alone May Not Protect Heart
Date:1/13/2011

By Jenifer Goodwin
HealthDay Reporter

WEDNESDAY, Jan. 12 (HealthDay News) -- High levels of HDL cholesterol -- the "good" kind -- have long been thought to help protect against heart disease. But new research finds that having high levels of HDL cholesterol may matter less than how well the good cholesterol functions -- that is, how well it works to rid the body of excess cholesterol.

HDL (high-density lipoprotein) cholesterol performs this clean-up by acting as a boat, removing unwanted cholesterol from cells called macrophages and transporting it to the liver, where the body can get rid of it. That helps prevent the cholesterol from getting stuck in the arterial walls, leading to the plaques that are a hallmark of heart disease, explained Dr. Daniel Rader, director of Preventive Cardiology at the University of Pennsylvania.

Low levels of HDL are strongly associated with an increased risk of heart disease, but the converse isn't always the case. For years, experts were perplexed at why some of those with high levels of HDL cholesterol were still at high risk of heart attacks. In fact, a trial for torcetrapib, a drug that raised levels of HDL cholesterol, was halted in 2006 when it emerged that people taking the drug were at heightened risk of heart attacks and death.

That led researchers to surmise there might be something about the way in which a person's HDL functioned that mattered more than HDL levels.

In the study, Rader and his colleagues took blood samples and measured the thickness of the blood vessel walls in the carotid artery of the necks of 203 healthy adults. The carotid thickness indicates arterial plaque and heart disease risk, Rader noted.

Researchers then took the HDL from the blood and applied it to macrophages derived from mouse cell lines. In humans and mice, macrophages are white blood cells that swallow invading microbes as a front line of defense; they also engulf cholester
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