Different way to measure good cholesterol better predicts heart attack and stroke risk

Doctor drawing blood

A little-used method for measuring HDL or ‘good’ cholesterol may be a better predictor of heart attack and stroke risk than the conventional method, according to NHLBI-funded research.

High levels of HDL, which helps remove cholesterol from the body, may lower the risk of heart attack, stroke, and other health problems. HDL is usually measured by assessing how much total HDL is inside HDL particles in the blood, a measurement known as HDL-C. In this study, reported in Circulation, researchers also looked at a method that isn’t commonly used called HDL-P that assesses how many particles of HDL are circulating in the blood.

Using data from more than 15,000 people from four national studies – the Dallas Heart Study, Atherosclerosis Risk in Communities study, Multi-Ethnic Study of Atherosclerosis, and the Prevention of Renal and Vascular Endstage Disease study – they found that men and women with the highest HDL-P levels had a lower risk of both heart attack and stroke compared with those who had the lowest HDL-P levels. In comparison, the conventional measurement, HDL-C, only predicted heart attack risk but not stroke.

However, when the researchers looked at data only from African Americans, neither HDL-P nor HDL-P was linked to risk of heart attack. The researchers are planning future studies to look more closely at HDL-P in African Americans as well as how the measurement can be used by physicians to make treatment decisions related to heart attack and stroke risk.