Investigators studied close to 10,000 patients with CAD in two separate cohorts...they found that individuals with HDL-C levels greater than 80 mg/dL had a 96% higher risk for all-cause mortality and a 71% higher risk for cardiovascular mortality than those with HDL-C levels between 40 and 60 mg/dL.
As I have stated for many years, the common lipid panel drawn by most labs today of Total Cholesterol, HDL, LDL and Triglycerides only measures "particles" and not HDL activity or even size of the LDL molecules like a VAMP test. It's like saying a car has 4 tires without recognizing that 2 of those tires might be flat, hence a car with 2 non-functional tires. So if a woman has an HDL of 80 mg and a total cholesterol of 350 mg not all 80mg of the HDL are functioning. The lab will generate a cardiac risk profile based upon Chol/HDL/LDL/Trig particles present in the blood. But how many of those particles are actually functioning? Which of the 4 tires are actually FLAT?
Photo by CDC on Unsplash
So we have to teach from medical school how to understand lab values and choosing either a more fat soluble statin versus a more water soluble statin coupled with teaching patients the importance of cooking methods; where Bake versus boiled versus frying ANY food, even if that food is a vegetable effects cardiac health.
Finally Estradiol, which pre-menopausal women produce, creates a HIGH HDL/LOW LDL profile while Testosterone which men produce creates a LOW HDL/HIGH LDL profile has resulted in women outliving men of their same age by 7 to 10 more years, because Estradiol helps women avoid the number one killer in the country HEART DISEASE. Go cougars!
Photo by Dr. Colin Ross
Who were the 10,000 people included in the study? More Men than Women or more Women than Men?
A 1 hour lecture from the RD about nutritional items commonly tested on USMLE exams while in medical school won't help achieve this level of understanding, but 30 minutes of my lecture "The three deadly ninjas of health" can help you understand how to raise that functioning HDL to protective levels if you are a man or woman.