Frequently Asked Questions
Expert Answers to Your Questions About Managing Lipids to Reduce Cardiovascular Risk
Q. How can I increase my HDL-cholesterol? And do I not need to worry about an increase in my LDL-cholesterol if my HDL-cholesterol (the “good” cholesterol) also increased?
A. We do not know that HDL protects from that increase in LDL-C, so it should still be addressed with your healthcare team. There are a lot of things that will raise HDL-C, and some of them are associated with reducing risk of heart disease. Stopping smoking and increasing your daily exercise will cause your HDL-C to go up and will reduce your risk for heart disease. But it’s unclear that the benefit is related to the change in HDL-C. People do sometimes think of HDL-C as being protective, or the “good cholesterol”, but the value that we measure when we measure HDL-C is not a value that actually informs us whether or not HDL-C is doing “good” or “bad” things in your body. As an example, if you increase the saturated fat in your diet, your HDL-C will go up but so will your LDL-C, and we know that increased saturated fat in the diet has been associated with higher risk for heart disease. Another example is drinking, which will raise your HDL-C. The more alcohol you drink, the higher the HDL-C will go. But only small amounts of alcohol have heart-healthy effects.
There have been some investigational medications that increase HDL-C, but they have not been proven to lower risk for heart attacks and strokes.
If your HDL-C is high, but you still have a very high LDL-C or you have diabetes or high blood pressure, those are all still considered to be independent risk factors for heart attack and stroke and should be discussed with your healthcare team.