You’ve probably heard of “good” HDL cholesterol and how it may affect heart health. Well, a new study is putting that under scrutiny.
A new, large-scale study shows that HDL cholesterol may not significantly affect heart health, particularly for Black people. A study of nearly 24,000 adults found that low HDL was associated with a somewhat higher risk for heart attack in white people, but that was not the case for Black adults.
On the other hand, high HDL levels – traditionally considered heart healthy – made no difference in the heart risks for Black or white adults.
Experts are now calling for a re-evaluation of how HDL is used to predict people’s risk of developing heart disease. Figuring out whether various “traditional” heart disease risks have similar effects on all people is now at the forefront.
HDL, or high-density lipoprotein, gained its reputation as “good” cholesterol in the Framingham Heart Study, which is still ongoing. In the 70s, researchers found a correlation between higher HDL levels and a lower heart attack incidence.
A decade ago, the study also identified other factors that are now considered key in whether or not people develop heart problems or suffer a stroke. Factors like high blood pressure, high levels of “bad” LDL, smoking, and obesity came out of Framingham.
The issue is that all the participants in the Framingham were white. More recent studies with more racial diversity have raised questions about whether low HDL is “bad” for everybody’s heart.
These new findings show that traditional beliefs do not hold up for Black Americans.
The study was published in the Journal of the American College of Cardiology and involved nearly 24,000 U.S. adults aged 45 and up who were free of coronary heart disease at the outset. About 42 percent of the participants were Black, and 58 percent were white.
Over the next decade, just over 1,600 people suffered a heart attack or died from coronary heart disease. It turned out that low HDL predicted a modestly higher risk of heart trouble in only white people. Among Black people, low HDL had no impact on risk.
Other research has found that HDL-raising medication offers no heart protection, either.
For Black patients, risk factors like high blood pressure, obesity, and high LDL should be weighted more heavily. However, those factors only go so far. Social inequities are the main reason why Black Americans are more likely to die from heart disease or stroke than white Americans.