Cholesterol in the bloodstream is carried within protein-rich packages known as ‘lipoproteins’. These come in two main types, so-called ‘low-density lipoprotein-cholesterol’ (LDL-C) and ‘high-density lipoprotein-cholesterol’ (HDL-C). Conventional wisdom has it that LDL-C is responsible for dumping cholesterol on the inside of arteries, and is dubbed ‘bad cholesterol’ as a result. On the other hand, HDL-cholesterol is said to be a sign of cholesterol being cleared from the inside of arteries, as is generally thought of as ‘good cholesterol’.
I was interested to read a recent study in which the associations between LDL- and HDL-C levels and degree of arterial disease were assessed in a group of individuals age 80 and over [1]. Arterial disease was assessed via calcium scoring. This test is believed to provide an accurate measure of the degree of build up of ‘atherosclerotic plaque’ on the inside of the arteries around the heart.
In this study, low levels of HDL-C were associated with higher calcium scores (and therefore the degree of arterial disease). This finding is consistent with conventional wisdom. However, this study also found that there was no association at all found between LDL-C levels and calcium scores in this population. This result does ask questions about the general assumption that higher levels of LDL-C are a ‘bad sign’ in older individuals.
In fact, there is evidence to the contrary.
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