Lipoproteins, whic h are combinations of lipids (fats)
and proteins, are the form in which lipids are transported in the blood. The high-density
lipoproteins transport cholesterol from the tissues of the body to the liver so
it can be gotten rid of (in the bile). HDL cholesterol is therefore considered the
'good' cholesterol. The higher the HDL cholesterol level, the lower the risk of
coronary artery disease.
Even small increases in HDL cholesterol reduce the frequency of heart attacks.
For each 1 mg-dl increase in HDL cholesterol there is a 2 to 4% reduction in the
risk of coronary heart disease. Although there are no formal guidelines, proposed
treatment goals for patients with low HDL cholesterol are to increase HDL cholesterol
to above 35 mg-dl in men and 45 mg-dl in women with a family history of coronary
heart disease; and to increase HDL cholesterol to approach 45 mg-dl in men and 55
mg-dl in women with known coronary heart disease.
The first step in increasing HDL cholesterol levels is life style modification.
Regular aerobic exercise, loss of excess weight (fat), and cessation of cigarette
smoking cigarettes will increase HDL cholesterol levels. Moderate alcohol consumption
(such as one drink a day) also raises HDL cholesterol When life style modifications
are insufficient, medications are used. Medications that are effective in increasing
HDL cholesterol include nicotinic acid (niacin), gemfibrozil (Lopid), estrogen,
and to a lesser extent, the statin drugs.
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