A study led by the Hospital del Mar Medical Research Institute (IMIM) has now found that not all good cholesterol is healthy, as some could increase the risk of heart disease.
The fact that even though the drugs that lower bad cholesterol reduces cardiovascular risk, those that raise good cholesterol have not proven effective in reducing the risk of heart disease. This mismatch has raised the question of the relationship between good cholesterol and cardiovascular risk, which led researchers to study the characteristics of good cholesterol particles.
The high-density lipoprotein cholesterol (HDL) or good cholesterol is linked with a decreased risk of cardiovascular disease as it transports cholesterol deposited in the arteries to the liver to be eliminated. While, the low-density lipoprotein cholesterol (LDL), the so-called bad cholesterol, increases the cardiovascular risk as it causes cholesterol to accumulate in the arteries.
During the study, the researchers analyzed genetic characteristics that determine the size of good cholesterol particles and then evaluated their link with the risk of myocardial infarction (heart attack).
The conclusion received from the study revealed that genetic characteristics linked to the generation of large-HDL particles are directly associated with an increased risk of heart attack, while features related to small-HDL particles lowers the risk of the disease.
“There is a positive causal relationship between the size of HDL cholesterol particles and the risk of heart attack, so although we have to increase the levels of good cholesterol in the blood, they must always be small particles”, explained the study’s principal investigator, Dr. Robert Elosua, a researcher at the Hospital del Mar-IMIM, CIBER on Cardiovascular Diseases (CIBERCV), and the University of the Vic-Central University of Catalonia (UVic-UCC).
If one needs to do something concerning HDL, it is to improve the number of small particles, which are those that adequately perform the function of eliminating cholesterol, those that move it to the liver for removal, and limits accumulation in the arteries and reduce cardiovascular disease. But, in the present condition, there are no drugs that increase good cholesterol levels and reduce the risk of cardiovascular disease.
“This study highlights new and potential therapeutic targets in the field of cardiovascular diseases, including several genes related to the qualitative aspects of HDL particles, which may contribute to cardiovascular prevention”, concluded Dr. Albert Prats, a researcher in the Epidemiology and Cardiovascular Genetics Research Group at the Hospital del Mar-IMIM and first author of the study.
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