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How Well Does HDL Work?

The most important measure of HDL cholesterol may not be how much there is, but rather how efficiently it works to remove cholesterol.

We frequently refer to high-density lipoprotein, aka HDL, as “good” cholesterol. But a study just published in The New England Journal of Medicine suggests that this is an oversimplification.

Scientists measured cholesterol, HDL cholesterol level, HDL particle concentration and a new marker called cholesterol efflux capacity in nearly 3,000 volunteers without heart disease. These people were followed up for more than 9 years as part of the Dallas Heart Study.

Cholesterol Carrying Capacity Counts

HDL cholesterol level did not predict heart attacks, strokes, stenting or bypass surgery. Cholesterol efflux capacity, a measurement of the ability of HDL to carry cholesterol away from the blood vessel linings to the liver, was much more useful.

People with the greatest cholesterol efflux capacity were 67 percent less likely to suffer cardiovascular complications compared to those with the least. This may be an important new marker for heart disease risk.

[New England Journal of Medicine, Nov. 18, 2014]

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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