HDL Function Appears to Control Cholesterol-Lowering Ability

The ability of HDL to remove cholesterol from the artery walls may be more important than the amount of HDL in the blood, researchers found in a study presented at the American heart Association 2014 Scientific Sessions.

“This finding is very interesting and could explain why medications to raise HDL have not yet improved outcomes in clinical trials and, in some cases, have increased the risk of death or cardiovascular events,” says Steven Nissen, MD, Chairman of Cardiovascular Medicine at Cleveland Clinic. “However, this is not the end of the story.”

In an effort to better understand how HDL functions, researchers measured HDL levels, particle concentration and cholesterol-efflux capacity in 2,924 adults without cardiovascular disease. Although age, gender and body mass index (BMI) affect HDL levels, these levels did not correlate with HDL functionality. Gender did not influence efflux capacity, and efflux did not appear to be associated with BMI, insulin resistance, lipid levels or body composition.

Participants in the highest quartile of cholesterol-efflux capacity had a 67 percent lower risk of developing cardiovascular disease, having a cardiovascular event or dying than those in the lowest quartile.