Ask the Cardiologist: Are there any benefits to treating low HDL?

hyperlipidemiaDr. Maciej Malinski is on the medical staff at Sherman Hospital. He has been kind enough to answer some frequently asked questions related to maintaining a healthy heart in his Ask the Cardiologist series. To see all posts Dr. Malinski has written, just type “Ask the Cardiologist” into the search bar on the right.

Q: Are there any benefits to treating low HDL?

A: Low HDL (high-density lipoprotein) cholesterol has long been recognized as a risk factor for cardiovascular problems. Over the past few years, medications designed to increase HDL have arrived with the intention that this therapy will lower the rate of cardiovascular events. The medications failed in preclinical trials, so details of their clinical effectiveness are still unconfirmed. The evidence for treating low HDL is, at best, equivocal. There is not a single trial designed to guarantee benefits of treating low HDL.

However, a great deal of evidence for treating LDL exists to reduce cardiovascular events in patients with cardiovascular disease, and also in patients at risk of developing cardiovascular problems. Treating low HDL alone with medications or using additional medication for treatment of elevated LDL is not well-proven to decrease heart risk. In addition, patients have to deal with increased risk of therapy (second medication), possible side effects, and increased cost (cost of medication and testing).

If LDL cholesterol is not well-controlled, addition of a second medication to lower LDL to the desired level is a well proven strategy. Therapy in this setting is very beneficial, and the magnitude of the benefit depends on the individual risk of developing cardiovascular disease in each patient.

While treating my patients, I always draw his or her attention to LDL cholesterol levels. This is a primary target for therapy to reduce the risk of having cardiovascular issues. It is not as important which medication or how many medications are utilized;  the goal is to lower LDL cholesterol to more desirable levels. Also, it should be noted that “natural” interventions to increase HDL (i.e.- exercise, or a low saturated fat/high fiber diet) strongly improve the cardiovascular system.

For more on this topic, see Dr. Malinski’s February 2011 article, “How Do I Get My LDL Number Down?”

Do you have a question for Dr. Malinski? To submit your question, post it in the comments section below, visit the Sherman Health Facebook page, or email with the subject line “Question for Dr. Malinski.” To schedule the essential (and painless) $79 Healthy Heart CT Scan, click here.

This post is published by Sherman Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from your physician.

About Sherman Health

Sherman Health has provided medical care to Northern IL since 1888, and is currently home to a network of over 600 physicians. The Sherman blogs are edited by me, Luke. Questions? Comments? Links? Email address is luke at shermanhealth dot com.
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