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March 24th, 2016

New Study, Mayo Cardiologist Sort Through the Mysteries of ‘Good Cholesterol’

By In the Loop

Fried eggs in a pan. Every once in a while, a study comes along that leaves you wondering what you just read and what it really means. Researchers at the University of Cambridge published a new study in the journal Science seems to throw sand on the traditional medical wisdom that says high levels of good cholesterol are beneficial for our hearts. "Twenty years ago, if you had high bad cholesterol and high good cholesterol, doctors said don't worry about it -- one offsets the other," Scott Wright, M.D., a cardiologist at Mayo Clinic, tells The Huffington Post in a story about the study. "I never really bought that ... You can have a heart attack despite having a high level of good cholesterol."

We asked Dr. Wright to help us sort through what the Cambridge study means. The study found that "some people with naturally high good cholesterol due to a genetic mutation" are actually at an elevated risk for heart disease. 

First of all, Dr. Wright tells us, cholesterol is just one of a "large number of risk factors" that play into our chances of heart disease. Then he explained that "about two percent of the patients in that study had high levels of good cholesterol, but that wasn't helping them, because they lacked a receptor to allow their good cholesterol to dump all of the fats inside of it out of their body." For the rest of us, though, he says, there is some benefit. "For 98 percent of us, high or elevated levels of good cholesterol are relatively still a good thing. It's helping reduce our risk a bit."

The two percent of patients in the study who were not helped have what's called a SCARB1 gene mutation, which affects "1 out of every 1,700 people." Those how have it, though, are "at an 80 percent increased risk" for heart disease, according to Huffington Post.

We still needed a little help understanding.

"Here's how cholesterol works," Dr. Wright tells us. "Good cholesterol is like your garbage company, and bad cholesterol is like your FedEx and UPS driver – it delivers packages throughout your body. Good cholesterol takes the leftovers from those packages – the garbage, the recyclables, the bad stuff – and dumps it out of your body for you. But for the two percent of people who have this SCARB1 mutation, their garbage trucks don't empty. And so their cholesterol levels just get higher and higher and they're then stuck with all of those toxins circulating around in their blood. That's why it's so harmful for them."

Whatever your metaphor of choice, Dr. Wright and The Huffington Post say the "classic nutrition advice" still holds true when it comes to reducing our risk for heart trouble. (Refuse delivery when you hear a knock on the door?) "We can always lower our risk of heart attacks and heart disease by not smoking, losing weight, exercising regularly, keeping our blood pressure normal, keeping our diabetes well managed, eating a low-fat diet, and doing whatever we can to keep our lives as low-stress as possible," Dr. Wright says. "Those are the tried and true things that all of us can always do to reduce our risk."

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Tags: Cholesterol, Dr. Scott Wright, Good Cholesterol, Heart Disease, Practice story, research, Research News

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