What is the benefit of High-Density Lipoprotein (HDL)?

From the Guidelines

HDL is beneficial because it helps remove excess cholesterol from the bloodstream and transports it to the liver for processing and elimination, thereby reducing the risk of cardiovascular disease. The benefits of HDL are well-established, with high levels of HDL cholesterol being an indicator of a healthy cardiovascular system 1. HDL cholesterol plays a crucial role in removing surplus lipids from the blood, which in turn reduces the risk of cardiovascular complications.

Key Points About HDL

• HDL cholesterol transports lipids back to the liver for recycling and disposal, which helps to prevent the buildup of plaque in the arteries 1.
• High levels of HDL cholesterol are associated with a reduced risk of heart disease and stroke, with ideal levels being above 60 mg/dL.
• HDL has anti-inflammatory and antioxidant properties that help protect blood vessels from damage.
• Regular exercise, maintaining a healthy weight, avoiding tobacco smoke, consuming moderate amounts of alcohol, and eating a diet rich in healthy fats can help increase HDL levels and contribute to better cardiovascular health.

Importance of HDL in Cardiovascular Health

The relationship between HDL cholesterol and cardiovascular health is well-documented, with studies showing that high levels of HDL cholesterol can reduce the risk of heart disease and stroke 1. The mechanisms underlying the effect of exercise on HDL cholesterol levels are not fully understood, but it is thought that exercise enhances the ability of skeletal muscles to utilize lipids as opposed to glycogen, thus reducing plasma lipid levels 1.

Increasing HDL Levels

To increase HDL levels, it is recommended to focus on lifestyle changes such as regular exercise, maintaining a healthy weight, and eating a diet rich in healthy fats 1. Additionally, avoiding tobacco smoke and consuming moderate amounts of alcohol can also help to improve HDL levels. By making these lifestyle changes, individuals can improve their HDL levels and contribute to better cardiovascular health.

From the FDA Drug Label

Epidemiologic investigations have established that cardiovascular morbidity and mortality vary directly with the level of total-C, LDL-C, and triglycerides, and inversely with the level of HDL-C Decreased levels of high density lipoprotein cholesterol (HDL-C) and its transport complex, apolipoprotein A (apo AI and apo AII) are associated with the development of atherosclerosis.

HDL is considered good because high levels of HDL-C are associated with a lower risk of cardiovascular morbidity and mortality, and a lower risk of developing atherosclerosis.

• HDL-C has a protective effect against the development of atherosclerosis.
• Increasing HDL-C levels is thought to be beneficial for reducing the risk of cardiovascular disease 2

From the Research

Benefits of HDL

• HDL, or high-density lipoprotein, is often referred to as "good" cholesterol due to its role in reducing the risk of heart disease 3.
• Maintaining healthy levels of HDL is critical for decreasing the risk of heart disease, as it helps to remove excess cholesterol from the bloodstream and transport it to the liver for excretion 3.
• Low levels of HDL have been linked to an increased risk of cardiovascular disease, making it an important target for therapeutic interventions 4.

Effects of Exercise on HDL

• Regular exercise has been shown to improve HDL function, including its ability to facilitate cholesterol efflux, antioxidative, and anti-inflammatory properties 4.
• Aerobic exercise, in particular, has been found to increase HDL levels and improve lipid metabolism, which can help to reduce the risk of coronary heart disease 5, 6.
• Exercise has also been shown to improve the maturation and composition of HDL, as well as enhance reverse cholesterol transport, which can help to prevent atherosclerosis 5.

Therapeutic Targets for HDL

• Several therapeutic targets have been identified for raising HDL levels, including endothelial lipase, lecithin cholesterol acyl transferase, and apolipoprotein AI (apoAI) 3.
• ApoAI-based drugs, such as its mutated dimer (apoAI-Milano), a complex with phospholipids, and a mimetic peptide, are currently under development for raising HDL levels 3.
• Fibrates, a class of drugs that raise HDL and lower triglycerides, have been shown to be effective in preventing serious vascular events in people with previous cardiovascular disease 7.