Very high levels of the so called good cholesterol (high-density lipoprotein (HDL), may be associated with an increased risk of heart attack and death, warns a new to research presented at the European Society of Cardiology Congress 2018.

Results were presented by the study author Dr Marc Allard-Ratick, (Emory University School of Medicine, Atlanta, Georgia, USA).

This study was part of the Emory Cardiovascular Biobank. It investigated the relationship between HDL cholesterol levels and the risk of heart attack and death in 5,965 individuals, most of whom had heart disease, British Journal of Cardiology reports.

The study results

Participants were divided into five groups according to their HDL cholesterol level. They were followed for 4 years. What were the results?

Participants with HDL cholesterol 41–60 mg/dl (1.1–1.5 mmol/L) had the lowest risk of heart attack or cardiovascular death. Risk was increased both in participants with low levels (less than 41 mg/dl [1.1 mmol/L]) and very high levels (greater than 60 mg/dl [1.5 mmol/L) of HDL cholesterol, which produced a U-shaped curve when plotted graphically.

While the answer remains unknown, one possible explanation is that extremely elevated HDL cholesterol may represent ‘dysfunctional HDL’ which may promote rather than protect against cardiovascular disease,” The study authorDr Allard-Ratick said.

It may be time to change the way we view HDL cholesterol. Traditionally, physicians have told their patients that the higher your ‘good’ cholesterol, the better. However, the results from this study and others suggest that this may no longer be the case, he commented to The British Journal of Cardiology.

Read more about the ESC Congress HERE