New Castle News

May 21, 2012

Mitchel Olszak: Another medical truth falls by the wayside

Mitchel Olszak
New Castle News

NEW CASTLE — Everybody knows that if you want to lower your risk of a heart attack, it’s important to raise your HDL level.

The term refers to high-density lipoprotein, also known as “good” cholesterol. It’s the opposite of low-density lipoprotein, the “bad” cholesterol that blocks coronary arteries and causes heart attacks.

We’ve been instructed over the years that raising HDL levels in the blood helps to protect the heart, as does lowering LDL levels. This can be accomplished through a proper diet and aerobic exercise. Plus, there is an entire medical industry built around the research and marketing of drugs that either lower LDL rates or raise HDL levels.

It’s all based on settled medical science. No discussion, no debate.

Unfortunately, that no longer appears to be the case.

Detailed research published last week in the medical journal The Lancet cites data showing people with genes that give them high HDL levels have the same rates of coronary problems as individuals who are less inclined to have this genetic propensity.

The results suggest that higher HDL levels, while not harmful, are not particularly helpful, either.


How could years of medical research be wrong on what seems to be such a fundamental point? Well, it turns out that — generally speaking — people with high HDL levels have a statistically lower incidence of heart attacks. But that doesn’t mean their HDL levels contributed to it.

Instead, it may mean that the same genetic or lifestyle factors that reduce heart disease also raise HDL levels. Yet one apparently doesn’t have anything to do with each other.

Here’s how this might work: Suppose a study determined that people with blue eyes had higher incomes than people with brown eyes. Common sense tells us that eye color can’t directly impact income, so it would make no sense to undergo a surgical procedure to alter eye color for financial gain.

The same goes with HDL levels. Taking drugs to raise them probably won’t offer any benefit if the medications fail to address the other internal factors that lower coronary risk.

The Lancet article reveals the flaw in associating one health-related finding with another. For example, various studies over the years have claimed that drinking coffee either helps or harms your health. A new one last week claimed that people who drink coffee live longer than those who don’t.

But does that mean coffee deserves the credit? Or is there some unknown factor that adds to the average life span while it prompts the drinking of coffee?

So what is the average person to take away from The Lancet report: That it’s pointless to make an effort to lower your risk of heart disease?

No. The fundamental fact remains that certain actions which raise HDL levels offer protection. The research does not reject the view that a healthful diet and reasonable exercise aid the heart.

What the research does, however, is raise warnings about medical short cuts that include taking drugs to artificially raise HDL levels. There is still no magic pill that creates good health.