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Question about HDL
Anon_11642 posted:
Hi - I have had to take Lipitor 20 mg for several years - my mom had same problem so guess I take after her. Recently my cholesterol numbers are going higher so now I take 40 mg and will retest soon. My LDL was 130 which is high and cholesterol was 222 - so need to get them down. I dont have heart disease - just a cholesterol problem - HDL was 61 and triglecerides were fine.

My sister who is 3-1/2 years older than me doesnt need to take cholesterol medicine - as she takes after my father - her cholesterol was 99 and HDL was 135. No pills - this is without taking anything.

That is what I'm writing about - an HDL 135. NP said she has never seen it that high. She walks BUT I work out 1 hour every day at our fitness center - do the nustep for 30 minutes and lift weights and all other kind of exercises - 5 days a week - 1 hr per day - you would think my HDL would be higher - all I know what my sister does is go for a walk which would be comparable to what I do - we both eat healthy - I eat a lot of fruits and veggies too.

Just wondering why hers is so much better than mine - can you suggest ways I can up it some more??? Am doing everything I'm supposed to do - both of us are normal weight.

Anyway, thought I would ask here instead of researching on google. Do you know what would cause an HDL to get so high? I envy her - LOL.

Thanks - will look forward to some suggestions you may have. I am 70 and she is 74.
billh99 responded:
Cholesterol is a LOT, LOT, more complex than just the measurements of TC, LDL, HDL, and trig's.

It includes things like genetics, diet, exercise. And research things that even the mix of micrboes in the gut affects the levels of cholesterol.

Healthy fats (mono and poly unsaturated) raise HDL without affecting LDL. While saturated fats might raise both.

And transfats along with hydrogenated or partly hydrogenated fats are very bad.

Moderate levels of alcholo (1-2 drinks/day for a male) can help increase HDL. But heavy drinking can kill it.

You did not mention your trig levels. Mine was around 80. And by reducing carbs, I lowered it to about 40 and increased by HDL by 15 points. However, my cholesterol profile was much different than yours.

But there is lots of individual variations. There is a supplement, plant sterols/stanols which is included in some foods (Benacol margerine among others). It helps reduce cholesterol levels in most person, but in a some group it makes it go sky high.

Now for risk factors based on the tradional cholesterol measurements (TC, HDL, trig's (LDL is usually calculated from the others) your HDL of 61 gives a fair amount of protection for a male. And for females there is a max level, IIRC it is about 80-90. Levels above that amount don't give any more protection.

However, it seems that more detailed analysis of cholesterol indicates that the number of particles of LDL is more indicative of heart risk than the amount of cholesterol.

Cholesterol is a fat and won't mix with the water based blood. So it is carried in a package with Apolipoprotein to form a lipoprotein.

Different aplipoproteins form different cholesterol packages (LDL, HDL, and other sub-sets). And in some cases there are multiple different aplipoproteins in the package. Lp(a) is one of them that make the particle more "dangerous".

In general the more cholesterol the more the more the number of particles. But that does not happen in all people. It is called discordence. Some people with high cholesterol have low numbers of LDL cholesterol particles and thus have low risk.

And for HDL there are several sub-classes and not all are protective. In fact some people with very high levels of HDL have "defective" HDL which does not offer any protection.

You might want to talk to your doctor to see if getting an NMR test might be appropriate. That measures cholesterol particles. They also offer testing of some of the genes that affect cholesterol.

There is only one lab that does this, but it is available through the several of the national labs.

You might also ask your doctor if he knows of any research in your area. If so they might be interested in your and your sister.
cardiostarusa1 responded:

"I am 70 and she is 74."

That's wonderful. May you both live to 100 and beyond.

"I have had to take Lipitor 20 mg for several years / Recently my..."

While on the subject of statins, noteworthy, there are advanced blood tests, such as NMR and VAP, that show the SIZE of one's cholesterol particles, providing detailed info that can help to determine if one should really be on a statin.

Additionally, statins are good for some individuals, bad (side effects/adverse reactions, such as memory loss, muscle aches/pains) for others. On an individualized case-by-case basis, the benefits of taking a statin, at any dose, must clearly outweigh the risks.

On the positive side, statins may/can stabilize vulnerable plaque (VP).

VP hides well-away within the vessel wall (essentially a 0% blockage, but still unequivocal atherosclerosis), can't be seen with invasive X-ray angiography, causes no advance warning signs/symptoms, and is now recognized worldwide as the cause of the majority of heart attacks by way of plaque rupture causing a blood clot (thrombus).

Statins also have anti-inflammatory properties and as applicable to the patient, thus lowers C-reactive protein (CRP/hs-CRP). Inflammation is recognized as a major player in the development and progression of atherosclerosis.

Also, as reported, a risk factor merely increases the probability that one will develop cardiovascular disease, BUT doesn't 100% guarantee that one will develop it, nor does its absence (or even the absence of ALL known risk factors) 100% guarantee that one won't have a heart attack or brain attack.

L@@K back in the Media

Raising HDL Levels May Not Lower Heart Attack Risk

Gene Study Questions Impact of Increasing 'Good' Cholesterol Levels

And finally, it has been known for quite some time now that atherosclerosis begins (the process and progression of) at a very early age, even as early as in the pre-teen/teenage years.

Studies performed in the past have shown fatty streaks (represents the earliest precursor to plaque development and plaque is the pathological hallmark of atherosclerosis) as the beginning of atherosclerosis in the coronary arteries. Soft plaque (more dangerous and unpredictable than hard or calcified plaque) is the early stage of atherosclerosis.

Best of luck down the road of life.

Take care,


WebMD member (since 8/99)



Good to know for the primary and secondary prevention of heart attack and brain attack

Epidemiologic studies (EDS) have revealed risk factors (encompasses new, novel or emerging) for atherosclerosis, typically affecting the carotid, coronary, and peripheral arteries, which includes age, gender, genetics (gene deletion, malfunction or mutaton), diabetes (considered as being the highest risk factor), smoking (includes second and thirdhand), inactivity, obesity (a global epidemic, "globesity"), high blood pressure (hypertension), **low HDL (**now questionable, according to recent studies) high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, high homocysteine (now questionable), and high C-reactive protein (CRP/hs-CRP).


About com: Heart Disease

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