Lewis asked: hello welcome your health fast, Scientific American Podcast series!
Josh Fishman: This show focuses on the latest important health news and discoveries that affect your body and mind.
Each episode dives into one topic. Discuss diseases, treatments, and some controversies.
Lewis: It also demystifies medical research in ways you can use to stay healthy.
My name is Tanya Lewis.
Fishman: My name is Josh Fishman.
Lewis: it was Scientific AmericanSenior Health Editor of .
Today’s show had some surprising news about cholesterol. The so-called “good” stuff is supposed to protect your heart and arteries.and the doctor just Understand this.
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Fishman: Tanya, you go to the doctor for your annual checkup, right?
Lewis: of course. As any healthy editor does!
fishman: me too. You will be asked a lot of personal questions, cold stethoscopes will be applied to your skin, and doctors will draw blood for standard laboratory tests. Among those tests are two cholesterol values if you take them back.
Lewis: right. One is the level of low-density lipoprotein cholesterol (LDL). It should stay below 130 milligrams per deciliter, the lower the better.
The other is high density lipoprotein, or HDL. And it should stay above 40 milligrams per deciliter.
fishman: it means LDL is “badCholesterol leads to plaque clogging your arteries, heart disease, stroke, and other nasties.
On the other hand, HDL is “good” Cholesterol. I want more
Lewis: This reputation is good because HDL binds to LDL and carries the bad stuff to the liver. From there it is washed out of your body and can’t hurt you.
fishman: But… you know that old saying about having too much good stuff? Like good cholesterol.
Lewis: So could it be too much HDL?
fishman: Absolutely possible.Turns out there was actually too much HDL increase Potential for arterial and heart disease, exactly what we are trying to avoid.
Above 80 for men and 100 for women, stop saying milligrams per deciliter. Many recent studies have found this effect.
But in general no what the doctor said to the patient.
Kuyumi: Until recently, the teaching was that the higher the HDL, the lower the risk. So, traditionally, doctors have used very high HDL levels as a marker of a truly healthy cholesterol profile.
fishman: That’s the researchers behind some new research.
Kuyumi: My name is Arshed Quyyumi. I am a Professor of Cardiology at Emory University School of Medicine in Atlanta, Georgia.
fishman: He conducted a study of over 400,000 people in the UK who had no other risk factors predisposing them to heart disease. For men, HDL levels below his 40 or above his 80 increased the risk of heart disease and other diseases. For women, HDL levels above 100 were associated with increased risk.
Lewis: When you say “climbed”, how much risk are you talking about? A small increase of a few percentage points or a much larger increase?
fishman: Great question. We asked Quyyumi about the amount of extra risk people face.
Kuyumi: almost twice as high compared to the lowest risk group with levels of 40-60 when taken without assessing other risk factors such as LDL cholesterol, blood pressure and diabetes.
fishman: Even if he and his team considered these other factors, people with very high HDL had an 80% higher risk than normal.
Other studies also support this. One of them studied over 11,000 hypertensive patients. Those with HDL values below her 40 and above her 80 were found to have a much higher incidence of cardiovascular problems.
Lewis: Now let’s look at the numbers. Bad if your HDL is less than 40. 40 to 60 is fine. A range of 60 to 80 can be at risk. Anything above 80 for men and 100 for women is a pretty big risk.
fishman:yes. “Good cholesterol” means bad cholesterol that is 80 or more, 100 or more, and less than 40, depending on gender. The middle zone is the safe zone.
it’s a bit of a mystery now why If HDL gets too high, HDL should get worse. For example, why is a molecule helpful at level 45 but harmful at level 85? Molecules can change shape. As such, it does not stick tightly to circulating cholesterol and helps eliminate it from the body.
Lewis: interesting. I would like to return to the interesting thing you mentioned. There is a difference in where a man and a woman enter her HDL danger zone. You mentioned 80 or more for men, but 100 or more for women. why is that?
fishman: you’re right. There was a difference of 20 points between men and women. And honestly, neither the Quyyumi team nor anyone else really knows why.
Kuyumi: Part of it is thought to be just a difference in sex hormones. You know, the difference between estrogen, testosterone…. between men and women. There are also some genetic reasons for it. It really doesn’t work.
Lewis: I read that estrogen can increase and protect HDL in women.
In any case, according to these studies, a slightly over 80 HDL shouldn’t surprise women. Men in that range should be aware that they are at risk.
fishman: yes. And there shouldn’t be too many to surprise you. Overall, this study shows that about 7% of the general population reaches these horrifyingly high HDL levels.
Still, it’s not something to ignore. When a doctor sees 100 of her patients in his week, 7 of them fall into this HDL danger zone.
Lewis: What to do if a person is in the danger zone?
fishman: I also asked Quyyumi. Patients who guzzle 1-2 glasses of wine or liquor each day are told to cut back on alcohol, because heavy alcohol consumption raises HDL.
There are no drugs that lower high HDL. So the big thing he does is focus on treating LDL.
For example, statins are very effective in lowering LDL levels and he was using them.
Also, baby aspirin used judiciously can reduce blood clots that lead to heart attacks.
And one more thing…
Kuyumi: If sedentary, exercise should be encouraged. Exercise helps with everything.
Lewis: I’m going to keep running in the morning. And make sure to keep the “bad” cholesterol low and the “good” cholesterol in that happy middle zone.
fishman: My colleague Lydia Denworth calls this the Goldilocks Zone. Not too low, not too high, just right. You can read her new Science of Health column on HDL on her sciam.com in mid-May.
And now I call my doctor to schedule an annual checkup.
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fishman: Your Health Quickly is written and edited by Tulika Bose, Jeff DelViscio, Kelso Harper, and Alexa Lim. Our music was composed by Dominic Smith.
Lewis: Our show is part of Scientific American’s podcast, Science, Quickly. You can subscribe anywhere you can get a podcast.
fishman: And don’t forget to visit Sciam.com for updated and in-depth health news.
Lewis: Tanya Lewis.
Fishman: My name is Josh Fishman.
Lewis: I will be back in 2 weeks. Thank you for listening!
