The cholesterol story continues, but the emphasis placed on total cholesterol is finally fading. Now the heat is up on HDL, or the “good” cholesterol.
It’s almost sad that, after years and years of promoting high cholesterol as a risk factor for heart disease, the medical community has quietly backed off from this mistaken belief that total cholesterol is linked to heart disease. I should probably clarify that. Mainstream medicine has finally backed off from the idea of artificially lowering your total cholesterol with drugs actually saves lives.
It is true that those with high cholesterol are at an increased risk of having a heart attack and dying of cardiac causes. But lowering cholesterol with a drug like Lipitor or Crestor is just short of worthless. Lowering total cholesterol with lifestyle, however, will absolutely, positively save your life.
Listening to the commercials for drugs to lower cholesterol, you will no longer here the announcer list “high cholesterol” as a risk factor for heart disease. What a massive kick in the gluts. The drug that was developed to lower cholesterol should now not be used solely to lower the high cholesterol is was designed to affect. Kind of makes your head spin.
HDL, also called “good” cholesterol, was in the spotlight for a while. Since it is clear that low HDL cholesterol is bad for the heart and higher levels protected against heart disease the drug companies spent millions of research dollars to develop a drug that would raise HDL levels. They all failed miserably, actually increasing the rate of heart disease in clinical studies. For now, the research along these lines has halted (at least as far as I know…).
But this does not mean that higher HDL levels do not have an effect on heart disease. They clearly do. It’s just that the HDL molecule is far, far more complex than we ever imagined. It is actually a group of molecules, NOT a single molecule. Positive lifestyle choices will affect the entire class of HDL molecules, sending the protective HDL molecules higher and the less protective ones lower.
One thing that is well-known about HDL is that it can act as an antioxidant and an anti-inflammatory molecule. This is a good thing. It may also mean that, should you suffer a heart attack, the HDL molecule can swoop in an lessen the damage done.
You see, when you have an ischemic heart attack (or stroke, for that matter), the area that loses blood supply and dies off (called the infarct) is actually smaller than the total area that ultimately gets damaged. This means that, if the original area that loses blood supply is the size of a dime, by the time it’s all done, the tissue damage area in the heart may be the size of a quarter. We can all agree that less heart damage is a good thing.
This particular study gives those of us with low HDL levels an idea of how we can protect our hearts in the event of a worst-case scenario. Researchers looked at mice with the inability to produce Apolipoprotein a1 (apoA1). ApoA1 is a main component of the HDL molecule. So higher apoA1 can mean better protection in the event of a heart attack. It turns out that in the mice who could not produce apoA1, the damage to the heart was 125% larger than normal mice in the event of an ischemic heart attack.
However, when the researchers gave coenzyme Q10 (CoQ10) to the mice who could not produce apoA1, the extra damage went away. A simple supplement that supports the ability of a cell to generate energy could make the difference between life and death. In the normal mice, though, CoQ10 did not make a difference in the size of the damage.
Based on this, some of you may be throwing good money away (CoQ10 is expensive–you can check out some of them on Amazon by clicking here) if you are taking CoQ10 to protect your heart and your apoA1 levels and HDL levels are not low. On the flip side, if you have lower HDL and lower apoA1 (this value can be checked on a standard blood panel), it might be a very smart idea to begin supplementing with 50-100 mg of good CoQ10 daily.
An important note to add here. The statin class of drugs to lower cholesterol are notorious for also lowering levels of CoQ10 (CoQ10 and cholesterol are on the same metabolic pathway and are both blocked by these drugs).
Does this mean that patients with low HDL who are put on statins may actually have WORSE outcomes after a heart attack??? If this turns out to be true, this would be completely ironic since “low good cholesterol” is now one of the indications for giving someone this worthless class of drugs.