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Harvard Health Publications Focus on Cholesterol: Part 2

Focus On: Cholesterol — Why is HDL cholesterol good for you?

In this Issue:
Why is HDL cholesterol good for you?

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Focus On Cholesterol Harvard Medical School
ISSUE #2 OF 6 IN AN E-MAIL SERIES  
Featured Report
Healthy Eating for a Healthy Heart
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In this report, you will find practical eating guidelines based on the best science available. You'll read about how to achieve a healthy weight and eat well at the same time. You'll learn about the basics of a healthful (and tasty) diet, how to plan a balanced meal at home, and what to eat when you dine out. Finally, you'll learn about wholesome snacks and food substitutions, so that you don't feel deprived on the road to better eating. As an added bonus, we've included 40 heart-healthy recipes from EatingWell Media Group, publisher of EatingWell Magazine, healthy cookbooks, and EatingWell.com.

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In the Next Issue

Could heart-healthy HDL cholesterol also be good for the brain?

Additional Resources
•   Hypertension: Controlling the "silent killer"

Why is HDL cholesterol good for you?

You've probably heard HDL referred to as the "good" cholesterol. But you might not know what makes it so good. Why is some cholesterol helpful to the heart and other cholesterol (namely LDL) harmful?

A little about LDL

Cholesterol travels through the bloodstream in protein packages called lipoproteins. The lipoprotein of greatest concern is low-density lipoprotein (LDL), the so-called bad cholesterol. If your body produces more LDL than the cells can absorb, it lodges in artery walls and contributes to the buildup of atherosclerotic plaque.

Driving down LDL has been the main target for improving cholesterol levels. Powerful cholesterol-lowering drugs called statins are available to do just that. Studies have shown that taking a statin can cut the risk of developing and dying from heart disease by 30% to 40%.

And on to HDL

But there's more to the story of cholesterol and cardiovascular risk than LDL. Another key player is high-density lipoprotein (HDL), dubbed the "good" cholesterol. HDL removes LDL from the artery walls and ferries it back to the liver for processing or removal (see illustration).

How HDL helps

Cholesterol travels in the blood attached to lipoproteins. Low-density lipoprotein (LDL) enters the walls of arteries, where it contributes to the buildup of atherosclerotic plaque. High-density lipoprotein (HDL) removes LDL from the artery walls and carries it back to the liver. HDL also helps quell inflammation and protect the cells lining the arteries' inner surface (endothelium).

HDL also acts as:

  • an antioxidant. Researchers believe antioxidants can protect against coronary artery disease by preventing LDL cholesterol from reacting with oxygen, which leads to the progressive thickening and hardening of the walls of arteries.
  • an anti-inflammatory. Though inflammation is an essential part of the body's defenses, it can cause problems, too. In the heart, inflammation can trigger atherosclerosis, keep the process smoldering, and influence the formation of artery-blocking clots, the ultimate cause of heart attacks and many strokes.
  • an antithrombotic. Thrombosis is the forming of clots, and preventing these clots from forming in the coronary arteries can prevent heart attack and stroke.

People with low levels of HDL are more likely to have heart attacks and strokes; high levels appear to be protective. In the Framingham Heart Study, low levels of HDL were an even more potent risk factor for heart disease than high levels of LDL. Other studies have linked high HDL levels to a reduced risk of stroke, greater longevity, and better cognitive function in old age.

Luckily, there are things you can do to increase HDL, both in terms of medications to take and lifestyle changes to make. A later article in Focus On: Cholesterol will explore in detail the ways to increase HDL.

Featured In This Issue
Healthy Eating for a Healthy Heart
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Healthy Eating for a Healthy Heart

Featured Content:

Losing weight to help your heart
Putting theory into practice
Recipes
Sample meal plan for a week

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Harvard Medical School offers special reports on over 50 health topics. Visit our Web site at http://www.health.harvard.edu to find reports of interest to you and your family.

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