Women and HDL: Is “Good” Good Enough?

Women and HDL Is Good Good EnoughFor years, we have divided cholesterol into the “good” and the “bad.” High-density lipoprotein, or HDL cholesterol,
is the good kind, and having high HDL levels is considered protective against heart disease. Low-density lipoprotein,
or LDL cholesterol, is the bad kind,
and is associated with a higher risk
of heart disease.

However, research in the last several years has cast doubt on just how “good” HDL cholesterol actually is. And new research, published in the Journal of Arteriosclerosis, Thrombosis, and Vascular Biology, suggests that HDL is not protective in certain groups of postmenopausal women.

The study analyzed the data of over 1000 women, ages 45 – 84. While high HDL levels did indicate lower risk of atherosclerosis, commonly known as hardening of the arteries, in the study’s participants, this was not true for all subgroups. In particular, high levels of HDL cholesterol were associated with increased risk of atherosclerosis in women ten or more
years post-menopause, as well as in women who were older at the time of menopause.

However, certain types of HDL cholesterol were found to be protective against atherosclerosis
in every age group in the study, regardless of the subject’s age at menopause. High levels
of small-sized HDL particles were protective, whereas large-sized HDL particles were associated with increased risk. The research suggests that rather than looking at total HDL in post-menopausal women, healthcare practitioners may need to scrutinize the type of HDL in order
to assess the risk of heart disease.

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