In an article to be published in The New England Journal of Medicine online Sept. 22, the Hopkins researchers report that existing strategies to prevent heart disease have not addressed the best means to raise HDL cholesterol and instead have focused heavily on lowering LDL cholesterol, which leads to plaque formation and narrowing of the arteries that can cause heart attack.
"We have reached a turning point in the prevention of coronary heart disease from an emphasis during the last 15 years on lowering LDL cholesterol levels to an emphasis in the next decade on raising levels of HDL cholesterol," says article lead author and cardiologist Roger Blumenthal, M.D., an associate professor and director of the Ciccarone Preventive Cardiology Center at The Johns Hopkins University School of Medicine and its Heart Institute.
According to Blumenthal, existing guidelines from the U. S. National Institutes of Health and its National Cholesterol Education Program primarily emphasize lowering LDL cholesterol to control blood lipid levels without considering the alternative of raising HDL cholesterol as the primary or even secondary goal.
However, Blumenthal notes that every single milligram per deciliter increase in HDL cholesterol lowers a person's risk of suffering a fatal heart attack by about 3 percent. Low levels of HDL cholesterol are known to increase overall risk of dying from heart disease and, specifically, to increase risk of arteries narrowing again after angioplasty surgery to clear them. Low levels of HDL cholesterol, he says, are defined as less
Contact: David March
Johns Hopkins Medical Institutions