‘Good’ cholesterol may help combat inflammation in cardiovascular health

‘Good’ cholesterol may help combat inflammation in cardiovascular health


Written by Jennifer Huizen on April 22, 2021 — Fact checked by Anna Guildford, Ph.D.
Share on PinterestNew research zooms in on the role of ‘good’ cholesterol for preserving cardiovascular health. FG Trade/Getty Images

  • According to a new study, testing how well high-density lipoprotein (HDL), or “good,” cholesterol reduces inflammation may help identify people who are more likely to develop cardiovascular disease associated with atherosclerosis.
  • In the study, the anti-inflammatory capacity of good cholesterol was higher in people who did not experience cardiovascular events than in those who did.
  • Based on the findings, every 22% increase in anti-inflammatory HDL reduced the risk of experiencing a cardiovascular event during the next 10 years by 23%. The protective effect of increased HDL anti-inflammatory capacity was higher in women than men.

Researchers know that HDL, or good, cholesterol reduces inflammation. At healthy levels, HDL can also reduce the risk of stroke and heart attack.

So far, intervention trials using medications to improve or increase HDL levels have been unsuccessful. Also, some genetic research indicates that lifelong high or low levels of HDL do not seem to relate to cardiovascular outcomes, as expected.

That is why some cardiovascular risk prevention researchers are shifting their focus from circulating HDL levels to the actual functional ability of HDL.

Indeed, a research team from the Netherlands has studied the relationship between HDL’s ability to reduce inflammation and the risk of experiencing a first cardiovascular event.

“HDL are very complex particles with anti-atherosclerotic functions that are not reflected by measuring just the cholesterol quantity,” says senior study author Dr. Uwe J. F. Tietge, Ph.D., a professor and head of the Division of Clinical Chemistry at the Karolinska Institute in Stockholm, Sweden.

“Atherosclerosis [plaque buildup in the arteries] underlying cardiovascular disease is increasingly recognized as a disease with a strong inflammatory component, and a central biological function of HDL is to decrease inflammation.”

By analyzing data from 680 adults, the team found evidence to suggest that HDL’s ability to reduce inflammation is associated with a reduced risk of a cardiovascular event.

In the study, people who did not experience a cardiovascular event demonstrated higher anti-inflammatory HDL levels than participants who did experience a cardiovascular event.

“By using a novel research tool, our results provide strong support for the concept that plaque buildup in the arteries has an inflammatory component and that the biological properties of HDL particles have clinical relevance to cardiovascular disease risk prediction.”

– Dr. Uwe J. F. Tietge, Ph.D.

The study appears in the journal Circulation, which is the American Heart Association’s (AHA) flagship journal. It received funding from the Netherlands Organization for Scientific Research and the Swedish Heart-Lung Foundation.

HDL: A natural anti-inflammatory

HDL is called good cholesterol because it picks up excess cholesterol in the blood and takes it back to the liver, which breaks it down and helps remove it from the body.

HDL can also reduce inflammation in the cells lining blood vessels. This occurs because HDL removes cholesterol stored in macrophage foam cells in atherosclerotic plaques and carries it to the liver.

Atherosclerosis occurs when plaque accumulates on the inner walls of arteries. Plaque is a substance made of cholesterol, calcium, fat, and other molecules.

As plaque deposits grow, they can gradually narrow the blood vessel, reducing blood flow and oxygen delivery to parts of the body or organs.

If atherosclerosis is severe enough, it can lead to major health concerns, including stroke, heart attack, and death.

When HDL removes cholesterol from foam cells in plaques, it helps reduce the size of the plaque. By reducing its size, it also reduces the amount of inflammation associated with the plaque.

Because of these factors, healthcare professionals typically include circulating HDL levels in many cardiovascular risk assessment tools.

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