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Improve Your HDL For Heart Health

HDL i.e. High Density Lipoprotein is the good cholesterol. It is the sweeper of bad cholesterol and keeper of the good stuff. The high-density lipoproteins transport cholesterol from the tissues of the body to the liver so it can remove bad cholesterol from the bile. HDL cholesterol is therefore considered the "good" cholesterol. The higher the HDL cholesterol level, the lower the risk of coronary artery disease.

The risk of atherosclerosis and heart attacks is strongly related to HDL cholesterol levels. Low levels of HDL cholesterol are linked to a higher risk, whereas high HDL cholesterol levels are associated with a lower risk.

HDL values can be genetic. Certain families maintain a low HDL cholesterol levels and have a higher incidence of heart attacks than the general population, while families with high HDL cholesterol levels tend to live longer with a lower frequency of heart attacks.

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Life style factors and other conditions influence HDL cholesterol levels. HDL cholesterol levels tend to be lower in persons who smoke cigarettes, are overweight and inactive, and in people with type II diabetes mellitus.

HDL cholesterol is higher in people who are lean, exercise regularly, and do not smoke cigarettes. Estrogen increases a person's HDL cholesterol which explains why women generally have higher HDL levels than men do.

For individuals with low HDL cholesterol levels, a high total or LDL cholesterol blood level further increases the incidence of atherosclerosis and heart attacks. Therefore, the combination of high levels of total and LDL cholesterol with low levels of HDL cholesterol is undesirable whereas the combination of low levels of total and LDL cholesterol and high levels of HDL cholesterol is favorable.

Cardiologists suggest that an even small increase in HDL cholesterol reduces the frequency of heart attacks. For each 1 mg/dl increase in HDL cholesterol there is a 2 to 4% reduction in the risk of coronary heart disease.

If the level of HDL is low due to factors like heredity, Trans fats in the diet, smoking, type 2 diabetes, or sedentary lifestyle, the risk for heart and cardiovascular disease goes up in an individual with a high total or LDL cholesterol level. In other words, HDL is one of several types of cholesterol, fats or particles in the blood (triglycerides, LDL cholesterol, Lp(a), Apo B, others) that are monitored to better assess cardiac risk.

As published in Times of India, 2004, Indians are genetically predisposed to heart disease due to genetic disposition of low levels of good cholesterol (HDL) and high levels of bad cholesterol (LDL).

Medical experts preach that HDL levels have to be increased among Indians. Upendra Kaul, director, interventional cardiology, Batra Hospital claim that trial studies have shown that HDL can be raised by injections of a special protein called Apoliprotein Milano and by drugs like Torcetrapib.

Moreover maintaining healthy cholesterol, having a good diet and indulging in regular physical activity, reducing ghee/butter/oil intake to less than 1/2 kg per month all help improve HDL levels.

Dr. Robert Danoff, D.O., M.S., contributed in an article in that HDL can be improved by adopting certain lifestyle changes:

Weight reduction in those who are overweight. To put this into perspective, every 10 pounds of weight loss (not water weight) may lead to a 1.5 to 2 point rise in your HDL.

Diet modification. Eat a Mediterranean style eating plan with foods containing healthier fats (nuts, fish, avocado) and oils (canola, soybean, olive). Minimize or eliminate foods containing trans-fats (products containing partially hydrogenated vegetable oil, others) and saturated fats.  

Exercise regularly. Indian experts recommend at least 45 -60 minutes of brisk walking at least thrice week for overall heart health. This may increase HDL by 5 points.

Smoking cessation. Kicking the smoking habit will do more than decrease your risk for lung cancer; it'll also help protect your heart and cardiovascular system. In fact, quitting tobacco may raise your HDL by four points or more.

Increase fiber in diet. Include fruits, vegetables, nuts and whole grains to your diet.

Minimize simple carbohydrates. Foods like cake, cookies, highly processed cereals and breads can lower HDL and raise triglycerides.

For certain individuals the above measures are not enough to increase HDL into the healthier range. In such cases doctors may advice recommending supplements containing plant sterols (beta-sitosterol) and omega-3 fatty acids. Medications can also be used to increase HDL and the commonly prescribed ones are:

Niacin (vitamin B-3) in higher doses (500 mg to 2 grams) may increase HDL 15 to 35 percent.

Fibrates (fenofibrate, others) may increase HDL by 20 percent.

Statins (atorvastatin, rosuvastatin, others) may increase HDL by 15 percent.

Combination medication containing a statin plus niacin, such as Advicor or Simcor, may increase HDL by up to 50 percent.

To sum up: HDL is an important protector against heart disease. Asians are genetically prone to have low HDL levels. Maintaining an HDL level of 60mg/dl or above is sure prevention against developing heart disease. HDL levels are low due to hereditary factors, stress, smoking, alcohol, sedentary lifestyle, lipid lowering treatment. Exercising regularly is sure-shot-way to increase HDL. Besides exercise, eating plenty of wholegrain, green leafy vegetables, fruits and heart friendly foods will help boost up HDL levels. Doctors may recommend supplements and medications to increase HDL levels as well. Consult your medical practitioner to know the perfect approach to raising your HDL.

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So, besides the 'bad cholesterols' LDL and Triglycerides, surely keep an eye on the 'good cholesterol' as well.

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