Our News item on 6 June 2012 described a large international study that showed people with inherited raised plasma HDL cholesterol concentrations had no reduction in cardiac risk. Research published online in the New England Journal of Medicine on 5 November 2012 found that a drug that increased HDL cholesterol more than 30% did not reduce risk. It seems that there is not a cause and effect association between raised HDL cholesterol and lowered risk; both result from healthy life style factors like taking regular exercise.

The name ‘good’ cholesterol has been given to high density lipoprotein (HDL) cholesterol because people with higher plasma HDL concentrations have a lower risk of heart attacks and vice versa. The current theory is that a raised HDL causes a reduction in risk. A very large international study published online in the Lancet on 17 May 2012 compared the risk of heart attack in the general population with the risk in those with an uncommon inherited condition that gives rise to a raised HDL. There was no difference. In the general population, lifestyle factors such as exercise are known to reduce the risk of heart attack and also to raise HDL. The authors concluded that lifestyle factors rather than raised HDL concentrations cause the reduction in risk.

Research has suggested that a single blood cholesterol measurement in early adulthood can help predict the risk of developing coronary heart disease or stroke by the age of 75.

Between 1980 and 2018 cholesterol concentrations in 200 countries fell sharply in high income nations and rose in low- and middle-income nations.

A new study of all well-conducted trials of statin treatment has confirmed that low HDL (the ‘good’ cholesterol) increases the risk of heart attacks and the risk does not fall even when statins reduce the LDL (the ‘bad’ cholesterol) in those with low HDL levels.