Good Cholesterol in Doubt

  1. "Good" Cholesterol in Doubt

    http://www.nytimes.com/2012/05/17/h...esterol-found-not-to-cut-heart-risk.html?_r=1
     
  2. jcsd
  3. lisab

    Staff: Mentor

    Re: "Good" Cholesterol in Doubt

    Damn! My "good" cholesterol has always been really, really high! My ace in the hole is a joker :mad:.
     
  4. Ivan Seeking

    Ivan Seeking 12,535
    Staff Emeritus
    Science Advisor
    Gold Member

    Re: "Good" Cholesterol in Doubt

    I just drink a lot of coffee and hope for the best. :biggrin:
     
  5. Re: "Good" Cholesterol in Doubt

    They've been tooting this as fact for quite some time now, and doctors even prescribe regimens to raise the "good" cholesterol. This quite undercuts faith in the medical establishment.
     
  6. turbo

    turbo 7,366
    Gold Member

    Re: "Good" Cholesterol in Doubt

    My faith in the medical establishment has been shaken to the core, anyway. My "good" cholesterol numbers have been quite high for decades, despite the fact that I can happily survive on cheeseburgers, if left to my own devices.
     
  7. Re: "Good" Cholesterol in Doubt

    Amazing what a healthy diet and exercise will do. You likely won't even have to worry about any of this.
     
  8. Re: "Good" Cholesterol in Doubt

    I hate these medical studies. Everyday there's a new study contradicting previous studies, which then lead to the creation of health paranoia. I find it silly when a news channel report that researches have found that apples, or anions or whatever help to reduce heart disease and the rest of blah blah. It's like they have brought a groundbreaking discovery. Next day, I may find them reporting that researches have found that soda drinks decrease the possibility of having a heart attack.

    Man, my ancestors who lived in the past 50-100 years, were very healthy, active and strong. Their diet was mostly dates, barley and wheat, all of which were farmed by them in their own farms. Their lifestyle made them that way, whereas modern lifestyle has brought health obsession to the mainstream, thanks to all different kinds of unhealthy food that the world is saturated by. From fast and genetically modified food, to food filled with poisonous materials.
     
    Last edited: May 18, 2012
  9. Re: "Good" Cholesterol in Doubt

    Now, it seems, "bad" cholesterol isn't so bad. In fact, there's no such thing as "good" or "bad" cholesterol. If fact, get this, cholesterol turns out not to even be cholesterol!

    http://www.tulsaworld.com/scene/article.aspx?subjectid=361&articleid=20120519_222_D4_bDearP4428
     
  10. phinds

    phinds 9,046
    Gold Member

    Re: "Good" Cholesterol in Doubt

    My favorite advice from the medical world is, unfortunately, a spoof, but it is exactly what they SHOULD say, seems to me. The quote is

    "As far as we in the medical community are concerned, regarding diet, we don't have a damn clue what's good for you and we wish you would stop asking !"
     
  11. Re: "Good" Cholesterol in Doubt

    I was under the impression the ratio is important:

    From The LDL to HDL Cholesterol Ratio as a Valuable Tool to Evaluate Coronary Heart Disease Risk, Fernandez and Webb (2008).

    "A more tenable option that has been proven to be an accurate predictor of cardiovascular risk is the LDL-C/HDL-C ratio, which can be obtained from a standard lipid profile and is more accurate than LDL-C or HDL-C alone.... Changes in ratios have been shown to be better indicators of successful CHD risk reduction than changes in absolute levels of lipids or lipoproteins...."

    I think the paper is open access.
     
  12. Re: "Good" Cholesterol in Doubt

    Haha! I like it!

    Seriously though, we are all scientists. Every theory is only a theory, right? The best theory stands until it is disproven. I know there is a tendency to think any medical study is corrupt because of 'evil pharma' companies, and 'money grabbing' doctors and other things, but there is a lot of good work going on out there, at least in my opinion. Each thing learned seems to open up so many more things still to find out.

    Interestingly this study is not really news. A big meta-analysis back in 2004 showed a similar outcome. http://doctor.cardiovalens.com/newcvd/navnewsdisplay.asp?newsid=6613&cat=cvd
     
  13. Re: "Good" Cholesterol in Doubt

    Very rarely do to these kinds of studies establish causal connections. The lipid value that correlates best with fatal MIs and some other cardiovascular (CV) outcomes is the total cholesterol/HDL-C ratio. Ratios below 4 are considered lower risk. Ratios above 5 indicate higher risk. While elevated LDL-C is correlated with higher risk, as many as half the MIs occured in men with normal LDL-C levels in some studies. Many now believe that inflammation associated with unstable plaques in the coronary arteries (leading to clot formation) is the precipitating event for many MIs. High levels of C reactive protein (CRP) are correlated with this kind of inflammation. I gave some references in a previous thread in this forum (Bohm2:Statin therapy for healthy people with high cholesterol) . HDL-C is believed to play a role in stabilizing these plaques by removing LDL.

    Statins have never been considered very effective in raising HDL-C. They are effective in lowering LDL-C, but with one exception (rosuvastatin, Crestor), they are only approved for reducing future MIs in MI survivors (secondary prevention). The most dramatic increases in HDL-C seem to be associated with increased exercise. HDL-C exists in 5 known fractions, and it's the heaviest fractions that seem to be most effective. It may be that certain people with very high levels of HDL-C (possibly hereditary) have more of the lighter fractions which are less resistant to oxidation.

    http://www.jci.org/articles/view/1649

    http://heartdisease.about.com/cs/cholesterol/a/raiseHDL.htm

    http://www.ncbi.nlm.nih.gov/pubmed/15459089
     
    Last edited: Aug 19, 2012
  14. Re: "Good" Cholesterol in Doubt

    I only read the abstract, but it makes no mention of the (total cholesterol)/(HDL-C) ratio. The HDL-C value is included in the numerator. This ratio has been used as a fairly good predictor of the risk of cardiovascular disease for at least 25 years. The greater the ratio, the greater the risk. In any discussion of the effect of HDL-C levels on risk, this ratio should be mentioned. If there are increases in LDL-C and/or VLDL-C (which contain triglycerides) in addition to HDL-C, then the ratio may stay the same or increase. Evaluating HDL-C alone would not be an adequate analysis in terms of risk evaluation.

    EDIT: If anyone read this with a discussion of the statistical significance of the finding, it was deleted because I read the significance level as p=0.085 when it was in fact p=0.85, meaning there was no evidence of an effect of HDL-C alone on the risk for an MI. In post 12, rooted linked to a study where the significance level for an effect was p=0.08 which would not be statistically significant at the usual level (p=0.05), but would be suggestive enough to question it's clinical relevance as evidence for no effect. In general, statistical tests are not designed to evaluate the lack of an effect.
     
    Last edited: Aug 20, 2012
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