SOLNA, Sweden — For people watching their cholesterol, standard tests usually monitor how much plaque is building up in the arteries that could lead to heart trouble. Now, a new study finds there may be a better way of predicting someone’s risk for a heart attack.
Researchers in Sweden say checking the function of “good cholesterol” as it dampens inflammation may improve screening for cardiovascular disease. Patients with inflammatory biomarkers could then start using cholesterol-lowering statins and changing their lifestyles accordingly.
The new testing method measures the anti-inflammatory capacity of HDL (high-density lipoprotein), rather than the total amount in the blood. Healthy fats help remove “bad cholesterol” (or low-density lipoprotein) from blood vessels. Too much LDL can lead to clots, cutting off blood supply and triggering a heart attack.
“HDL are very complex particles with anti-atherosclerotic functions that are not reflected by measuring just the cholesterol quantity,” says senior author Professor Uwe Tietge from the Karolinska Institute in a statement to SWNS.
“Atherosclerosis [plaque build-up 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.”
Less inflammation keeps the heart healthy
Assessing these levels is already standard clinical practice. The new method offers hope of providing additional information independent of the quantity. The study, appearing in the journal Circulation, is the first to analyze if better working HDL stops serious heart-related events.
Researchers studied 369 older Dutch adults, tracking them for around a decade on average. Half of the participants developed heart disease during the follow-up period. The team also matched these individuals by age, sex, smoking status, and HDL levels with a control group of 369 healthy people.
Lab tests at enrollment included measuring a protein marker of inflammation, C-reactive, and the ability of isolated HDL particles to decrease it. Study authors also looked at how efficiently HDL removed cholesterol from cells resembling those in plaque. The results reveal HDL anti-inflammatory power is significantly higher in people who remained healthy (32%) than in those who experienced a cardiovascular event (27%).
Better cholesterol means better health for women
Researchers add this link appears to be independent of traditional biomarkers for HDL cholesterol, C-reactive levels, and cholesterol capacity. For every 22 percent increase in the ability of HDL particles to suppress inflammation, participants were 23 percent less likely to have a cardiovascular event. Researchers add this protection was higher in women.
“Our results point to new opportunities for improved cardiovascular risk assessment by using a biologically meaningful functional biomarker for HDL instead of its cholesterol content,” Prof. Tietge says in a university release. “However, the method for analyzing the anti-inflammatory activity of HDLs is currently rather complex and difficult. Our next goal is therefore to make the method simpler and more clinically implementable.”
The findings also raise the possibility that scientists can develop drugs to improve HDL anti-inflammatory capacity and lower heart disease risk. Cardiovascular disease is the number one killer worldwide and responsible for one in four deaths in the U.S. each year.
SWNS writer Mark Waghorn contributed to this report.