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"Are high HDL cholesterol levels dangerous?"


I am a 35 year old woman and my HDL cholesterol is very high. Is this dangerous? It's supposed to be the good kind but it's still very high.


HDL works in a number of ways, but importantly it helps transport other cholesterol particles from tissues and blood back to the liver, including helping to remove “bad” or low-density liopoprotein (LDL) cholesterol from plaques in arteries. High concentrations of LDL cholesterol are associated with increased plaque formation in the arteries, and it is these plaques that can narrow arteries or rupture and cause heart attacks and strokes. In general, the higher your HDL level the better and having a level above 60mg/dL has been considered cardioprotective.

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In fact, only a few years ago a new drug was studied that had the effect of significantly raising the levels of HDL cholesterol. Unfortunately, taking the study medication was associated with worse outcomes, which was a significant surprise. It is still unclear whether it was merely a problem with the drug or if actually having very elevated levels of HDL caused the poor outcomes. A study published last year tried to partially answer this question. The study found that in patients with certain conditions such as autoimmune diseases having an elevated HDL in addition to an elevated CRP level was associated with worse outcomes. (CRP is a blood protein that is elevated due to inflammation from many different causes.) So it is not quite clear now that always having a very high HDL is good, especially if you have other medical problems such as rheumatoid arthritis or lupus. Unfortunately, it will likely take more time and studies before physicians better understand this issue. Your primary care physician or cardiologist can best discuss your results to help you understand how they might affect your health. Good luck!

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