what contributes to high hdl and how to correct it

More HDL cholesterol is better, but the benefits may depend on how you get in that location.

In the simplest telling of the cholesterol story, HDL (the so-chosen good cholesterol) fights LDL (bad cholesterol). Like knights in shining armor, HDL particles patrol the blood vessels, snatching cholesterol from circulating LDL particles and from the dangerous, gooey plaque that lines artery walls. The knights of the HDL cholesterol conduct their fatty cargo to the liver for recycling or disposal.

Thereal story isn't quite and so simple. HDL cholesterol is turning out to exist a much more complex substance than we once believed. Instead of a single kind of particle, HDL cholesterol is a family unit of different particles. Although they all contain lipids (fats), cholesterol, and proteins called apolipoproteins, some types are spherical while others are doughnut-shaped. Some types of HDL are great at plucking cholesterol from LDL and artery walls while other types are indifferent to cholesterol, and some even transfer cholesterol the wrong way — into LDLand cells.

To further complicate matters, unlike HDL types do more just deport cholesterol. Some protect LDL from being chemically contradistinct by oxygen, a change that makes LDL extra harmful to avenue walls. Nether some circumstances, though, they can do but the opposite. Various HDL particles can ease inflammation in avenue walls, stimulate production of nitric oxide, a molecule that helps artery walls relax, and assistance preclude blood clots from forming inside arteries.

This diverseness of function, and the equivocal evidence for the benefits of raising HDL, go on the spotlight on lowering LDL as part of the showtime line of defense in the fight against heart disease. Notwithstanding, information technology is a good idea to try raising HDL when information technology is low. A depression HDL is under 40 milligrams per deciliter of blood (mg/dL).

What causes low HDL cholesterol?

In that location are many reasons why some people have depression HDL and others have high HDL. Genes announced to play the most of import role past determining how much HDL cholesterol your body makes and the proportion of different subtypes.

Lifestyle choices also affect HDL levels. Smoking, carrying likewise many pounds, and lack of physical action tend to lower HDL. So does a nutrition high in refined carbohydrates (white breadstuff, sugars, etc.). Medications such as beta blockers, anabolic steroids, progestins, and benzodiazepines can likewise depress HDL.

Anatomy of an HDL particle

Poor ILLUMINATE-tion

Two kinds of medications have traditionally been used to heighten HDL cholesterol: niacin, which is too known as vitamin B₃, and fibrates, such equally gemfibrozil (Lopid, generic) and fenofibrate (TriCor, generic). However, nearly clinical trials accept non shown a direct correlation betwixt raising the HDL cholesterol level and less heart affliction, or fewer heart attacks and strokes.

The equivocal results have some experts questioning whether the monetary and physical costs of taking niacin or a fibrate are worth the uncertain benefits.

A drug chosen torcetrapib was specifically designed to enhance HDL cholesterol by blocking cholesteryl ester transfer protein (CETP), which is involved in the transfer of cholesterol between LDL and HDL. Notwithstanding in a major clinical trial called ILLUMINATE, reported in 2007, torcetrapib was a flop. Although information technology increased HDL past a whopping 60%, the volunteers who took torcetrapib didn't accept any reduction in atherosclerosis compared with those taking a placebo. What they did accept were small increases in claret pressure, as well equally more than cases of heart failure and procedures to open or bypass a blocked artery. The trial was stopped early on on condom grounds, since volunteers taking a placebo were faring better than those taking torcetrapib.

The results torpedoed torcetrapib'southward chances of becoming a blockbuster drug, something its maker, Pfizer, was hoping for. They called into question the strategy of raising HDL by blocking CETP. And they as well had some experts questioning all-embracing strategies for boosting HDL levels without paying close attention to the structure and function of the new HDL particles induced past the drug.

What to do

Cholesterol guidelines focus on lowering elevated LDL cholesterol first. If HDL cholesterol rises that is fine, but it should not be the reason for drug therapy. A high HDL doesn't cancel out high LDL when it comes time to determine whether to first lifestyle or drug therapy. Instead, HDL takes a back seat to LDL.

That said, it is prudent to do what you tin to boost your HDL cholesterol, especially if information technology is under 40 mg/dL. Changes in lifestyle should be first on your list, since they practise other wonderful things for the heart, basic, muscles, and psyche and have no harmful side furnishings. They include:

• Exercising more than.  Vigorous exercise is best for boosting HDL cholesterol, but whatsoever extra exercise is better than none.
• Losing weight.  If you are overweight, losing 5% to ten% of your electric current weight can raise HDL cholesterol, along with reducing blood pressure and blood saccharide.
• Cutting back on refined carbohydrates.  Switching from refined carbohydrates to whole grains and adding more lean protein to your diet is a skilful dietary approach to increasing HDL.
• Stopping smoking.  Quitting can meliorate HDL cholesterol and do so much more for your eye and wellness.
• Moderate alcohol intake.  Drinking alcohol in moderation (no more 1 drink a 24-hour interval for women, ane to two for men) raises HDL. If you don't drink, in that location's no need to start — exercise, losing weight, and other lifestyle changes are enough.

Taking an LDL-lowering statin tin also improve HDL cholesterol, though you wouldn't start a statin for this purpose because the effect is small.

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Source: https://www.health.harvard.edu/newsletter_article/hdl-the-good-but-complex-cholesterol