Is your HDL (good cholesterol) an indicator of heart disease risk?
A latest study by REGARDS (Reasons for Geographic and Racial Differences in Stroke) found that while HDL is singularly linked with an increased risk of heart disease in White Americans, it alone was not a trigger among African-American adults.
The study, published in the Journal of American Cardiology, is significant, say cardiologists, noting that there is a need to look beyond a single lipid fraction. This holds particularly true among Indians. For us HDL levels matter very little in countering the effects of low-density lipoprotein (LDL) or bad cholesterol. This leads to fatty build-ups in arteries, narrowing them and increasing the risk for heart attack, stroke and peripheral artery disease.
“It is more like a combination key than a single key turning the atherosclerotic lock,” says Dr K Srinath Reddy, honorary distinguished professor at Public Health Foundation of India (PHFI).
Why Indians should be more worried about LDL, Triglycerides
“Indians have a low HDL. They say 50mg/dL HDL is ideal to neutralise LDL but in Indians, that level never crosses 45 mg/dL in the best of times. Which is why we should only focus on the LDL levels and keep them low. In fact, over the last three decades, the safe limit for LDL has been pushed down and for Indians, who are genetically prone to cardiac conditions, the LDL levels are the only concern,” says Dr Balbir Singh, Chairman, Cardiac Sciences, Cardiology, Cardiac, Electrophysiology-Pacemaker, Max Hospital, Saket.
“Internationally, they prefer LDL levels to be less than 70 mg/dL but for Indians, I would say less than 50 mg/dL. Heart disease among Indians is compounded by additional risk factors like family history, smoking, stress, hypertension and diabetes. So many young Indians are getting a stent in early ages,” he says.
The other worrisome factor is triglycerides. “LDL levels need to be reworked for some people in combination with co-morbidities, high triglycerides and body weight. Triglycerides are blood fat, which along with cholesterol, cause plaque build-up. Therefore, both triglycerides and LDL levels need to be significantly lower,” says Dr Singh.