HDL is Not Always Protective — Especially for Older Women

We all know that cholesterol comes in two types: the “good” and the “bad.” High-density lipoprotein (HDL) is the good kind; having high HDL levels is considered protective against cardiovascular disease. Low-density lipoprotein (LDL) is the bad kind; it is associated with a higher risk of cardiovascular disease.

But recent research has cast doubt on just how “good” HDL really is, particularly for women. One study, published in the Journal of Arteriosclerosis, Thrombosis, and Vascular Biology, suggests that for certain groups of postmenopausal women, HDL does not live up to its reputation.

The study analyzed the data of over 1000 women, ages 45-84, finding that high HDL may indicate lower risk of atherosclerosis (hardening of the arteries) in some participants, but not all. In particular, high HDL was 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.

That’s not to say that HDL is not at all protective. Certain types of HDL cholesterol were found to be protective against atherosclerosis in every age group, and 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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