There is good cholesterol and bad cholesterol. This is something that we’re taught from early on in our adult lives as a way of lowering our risk for cardiovascular disease later in life. Traditionally, HDL cholesterol is considered one of these “good” cholesterols.
HDL is actually a group of cholesterol that can vary in size and cholesterol content found in the bloodstream. This family of cholesterols moves cholesterol away from the heart, which helps to reduce the build-up of plaque and our overall risk of cardiovascular disease.
A new study, however, has found that the “good” HDL cholesterol may not have the same effects on lowering cardiovascular risk in post-menopausal women. The participants consisted of 1,138 women between the ages of 45 and 84. Some of the women are still continuing follow-ups as part of the data collection. The total number of HDL particles and total HDL cholesterol were documented prior to, during, and post-menopause.
What they’ve discovered is that the presence and quantity of HDL in the system of the participants who have gone through menopause is no longer a reliable predictor of cardiovascular disease risk. The results showed an association between increased levels of HDL cholesterol and increased risk of plaque build-up, particularly in the women who were 10 years or more into post-menopause.
Quality and Size of HDL Particles Effects Cardiovascular Disease Risk
Interestingly, a higher concentration of total HDL particles (not just HDL cholesterol) as well as smaller HDL particles was associated with a decrease in the risk of cardiovascular disease. This was found to be true despite the participants’ age or the length of time since menopause occurred. Larger HDL particles were linked to an increased risk of cardiovascular disease when they were present close to menopause, however.
The researchers hypothesize that these results are due to the vast changes in physiology women undergo during and after menopause. They believe that the sudden lack of estrogen, as well as other metabolic changes associated with menopause, causes chronic inflammation.
This is changing the characteristics of the HDL particles found in the blood so that they no longer have the same beneficial effects against cardiovascular disease. The researchers did note that the farther away from menopause the women were, the better quality the HDL particles had, restoring their benefits against heart disease.
“The results of our study are particularly interesting to both the public and clinicians because total HDL cholesterol is still used to predict cardiovascular disease risk,” said lead author Samar R. El Khoudary, Ph.D. “This study confirms our previous work on a different group of women and suggests that clinicians need to take a closer look at the type of HDL in middle-aged and older women, because higher HDL cholesterol may not always be as protective in postmenopausal women as we once thought. High total HDL cholesterol in postmenopausal women could mask a significant heart disease risk that we still need to understand.”
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