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High-density Lipoproteins (HDL)

Note:  I see a lot of orders for no-flush niacin.  I assume the reason people are buying this is to raise HDL cholesterol.  I couldn't find any research that no-flush niacin works to increase HDL.  It's probably a waste of money for the no-flush.  Just do a Medline search of  hexanicotinate HDL, hexaniacinate HDL or no-flush niacin.  Here are the the only studies I could find:

Accumulation of chylomicron remnants and impaired vascular reactivity occur in subjects with isolated low HDL cholesterol: effects of niacin treatment - Atherosclerosis. 2006 Jul;187(1):116-22 - "evaluation of no-flush niacin treatment ... Twenty-two low HDL subjects with reduced FMD were randomized into two groups, one given 1.5 g/day niacin and a placebo group. After 3-month treatment, plasma lipids and chylomicron kinetics were not changed by niacin treatment"

Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia - Ann Intern Med. 2003 Dec 16;139(12):996-1002 - "Commonly used over-the-counter niacin preparations (500-mg tablets or capsules) from the 3 categories of immediate-release, sustained-release, and no-flush were purchased at health food stores and pharmacies and from Internet-based vitamin companies ... The average content of free nicotinic acid was 520.4 mg for immediate-release niacin, 502.6 mg for sustained-release niacin, and 0 for no-flush niacin ... No-flush preparations of over-the-counter niacin contain no free nicotinic acid and should not be used to treat dyslipidemia. Over-the-counter sustained-release niacin contains free nicotinic acid, but some brands are hepatotoxic. Immediate-release niacin contains free nicotinic acid and is the least expensive form of over-the-counter niacin"

I’ve been taking three grams per day of the immediate release niacin (Twinlab).  It raised my HDL from 39 to 57.  Then I switched from Actos to Avandia (both to prevent diabetes) and my HDL went back down to 47. I’m switching back to Actos when I run out of Avandia. I don’t experience any flushing from the IR anymore. I think it took a couple months to get used to it plus I built up to three grams gradually. The IR didn’t have any noticeable effect on my liver enzymes. My ALT is 35. My doctor thinks that’s great. Normal goes up to 60 but I read that you want it below 30 but the 35 was about what it was before the niacin. My father died of liver cancer so I keep an eye on my liver enzymes but my father drank like a fish plus he was 87 when he died.  See:

Elevated ALT Levels Predict Risk of Death From Liver Cancer - Medscape, 11/2/06 - "Upper limits of normal range from 30 IU/L to 60 IU/L, depending on the laboratory. "We want to reset it southward of 30 IU/L," ... ALT levels are a reflection of the general vascular condition ... If the level is above 30, then that person probably has a problem — fatty liver or some vascular disease, including occlusive coronary artery disease"

http://www.lipidsonline.org/slides/slide01.cfm?tk=25&dpg=34 shows that with extended release niacin, HDL peaks out at 2,500 mg.  http://www.lipidsonline.org/slides/slide01.cfm?q=effect+of+niacin&dpg=4 shows immediate release crystalline niacin compared to Niaspan.  There isn't much gain in HDL with the immediate release crystalline niacin after 1,000 mg per day.  After seeing that, I'll probably cut down from 3,000 mg but from the slide it appears that there is a significant advantage to lowering triglycerides by going to 3,000 mg plus there is a linear decrease in LDL-C by going to 3,000 mg immediate release crystalline niacin.  This graph also shows that immediate release crystalline niacin is significantly better at raising HDL and lowering triglycerides compared to Niaspan.  Also see the slide titled CHD Risk According to HDL-C Levels.

I’ve never seen any studies on Niaspan and liver damage but it would seem like it would be similar to the slow release niacin. The only study I’ve seen on that is:

A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients - JAMA. 1994 Mar 2;271(9):672-7 - "None of the patients taking IR niacin developed hepatotoxic effects, while 12 (52%) of the 23 patients taking SR niacin did"

Be sure to see a doctor to have your liver enzymes checked before and after taking any niacin supplement.  See the bottom of http://www.lipidsonline.org/slides/ for some great slide shows on HDL.  The January 2007 Harvard Men's Health Newsletter has a good article on HDL cholesterol but it is a paid subscription.  See niacin at Amazon.com and niacin at Amazon.com.

Related Topics:

• cholesterol / homocysteine / inflammation / heart disease / strokes / red yeast rice / policosanol / guggul / pantethine / artichoke / inositol hexanicotinate / triglycerides / statins / green tea / hesperidin / hypertension / trans fatty acids

Popular Supplements:

• niacin / policosanol / hesperidin / beta-glucan / red clover / red yeast rice / fish oil / coenzyme Q10

Alternative News:

• Lipid metabolism disorders and lipid mediator changes of mice in response to long-term exposure to high-fat and high sucrose diets and ameliorative effects of mulberry leaves - Food Funct 2022 Mar 31 - "Mulberry leaves exhibit anti-lipogenic and lipid-lowering effects. However, the lipid biomarkers and underlying mechanisms for the improvement of the action of mulberry leaves on obesity and lipid metabolism disorders have not been sufficiently investigated yet ... mulberry leaf water extract (MLWE) ... Our results showed that MLWE supplementation not only decreased body weight gain, serum total triglycerides, low-density lipoprotein cholesterol, alanine transaminase and aspartate transaminase levels, but also increased the serum level of high-density lipoprotein cholesterol. In addition, MLWE supplementation also ameliorated hepatic steatosis and lipid accumulation" - See mulberry leaf extract at Amazon.com.
• Lipid and glucose levels at age 35 associated with Alzheimer's disease - Science Daily, 3/23/22 - "lower HDL (the good cholesterol) is predictive of AD in early (35-50 years) and middle (51-60 years) adulthood and that high glucose in the blood (a precursor of diabetes) during mid-adulthood is also predictive of AD "These findings show for the first time that cardiovascular risk factors, including HDL which has not been consistently reported as a strong risk factor for AD, contribute to future risk of AD starting as early as age 35," ... careful management of these factors starting in early adulthood can lower one's risk of cardiovascular disease and diabetes, as well as Alzheimer's."Intervention targeting cholesterol and glucose management starting in early adulthood can help maximize cognitive health in later life,""
• Higher free triiodothyronine is associated with higher HDL particle concentration and smaller HDL particle size - J Clin Endocrinol Metab 2022 Feb 2 - "In euthyroid individuals, higher FT3 is cross-sectionally associated with higher total HDL particle concentration and with lower HDL particle size. These associations may be relevant to better understand the role of HDL in thyroid function-associated atherosclerotic cardiovascular disease"
• Healthier Lipid Profiles with Vitamin D Supplementation in a Pilot Study in Argentinean Children of Two Ethnicities - Int J Vitam Nutr Res. 2017 Aug 21:1-8 - "These results suggest that children who had received vitamin D supplementation had significantly higher vitamin D status and HDL-C, as compared with non-supplemented children in both communities" - See vitamin D at Amazon.com.
• Effects of L-carnitine supplementation on lipid profiles in patients with coronary artery disease - Lipids Health Dis. 2016 Jun 17;15(1):107 - "LC supplementation at a dose of 1000 mg/d showed significantly increased in HDL-C and Apo-A1 levels and a slight decrease in TG levels but no other changes in other lipids in CAD patients, and this lipid-lowering effect may be related to its antioxidant ability" - See L-carnitine at Amazon.com.
• Polyphenol rich olive oils improve lipoprotein particle atherogenic ratios and subclasses profile: a randomized, crossover, controlled trial - Mol Nutr Food Res. 2016 Mar 15 - "Polyphenols from olive oil and thyme modified the lipoprotein subclasses profile and decreased the LDL-P/total HDL particle (HDL-P), small HDL/large HDL, and HDL-cholesterol/HDL-P ratios, and decreased the lipoprotein insulin resistance index (LP-IR)" - See olive leaf extract at Amazon.com.
• A systematic review and meta-analysis of the impact of Spirulina supplementation on plasma lipid concentrations - Clin Nutr. 2015 Sep 25 - "This meta-analysis showed a significant effect of supplementation with Spirulina in reducing plasma concentrations of total cholesterol, LDL-C, triglycerides and elevating those of HDL-C" - See Spirulina at Amazon.com.
• Higher-Protein Diets Are Associated with Higher HDL Cholesterol and Lower BMI and Waist Circumference in US Adults - J Nutr. 2015 Mar;145(3):605-14 - "Americans of all body weights typically consume protein in excess of the RDA. Higher-protein diets are associated with lower BMI and waist circumference and higher HDL cholesterol compared to protein intakes at RDA levels. Our data suggest that Americans who consume dietary protein between 1.0 and 1.5 g/kg BW potentially have a lower risk of developing cardiometabolic disease"
• Effects of Spirulina platensis supplementation on lipid profile in HIV-infected antiretroviral naive patients in Yaounde - Cameroon: a randomized trial study - Lipids Health Dis. 2014 Dec 13;13(1):191 - "Patients were randomized and received either Spirulina supplementation combined with local diet (n = 82) or local diet only (n = 87) ... there is a significant increase in HDL-cholesterol and a significant decrease in total cholesterol, LDL-cholesterol and triglycerides in the group of patients who consumed Spirulina platensis" - See spirulina at Amazon.com.
• Administration of high dose eicosapentaenoic acid enhances anti-inflammatory properties of high-density lipoprotein in Japanese patients with dyslipidemia - Atherosclerosis. 2014 Oct 18 - "Oral administration of EPA regenerated anti-oxidative and anti-inflammatory functions of HDL, and promoted cholesterol efflux from macrophages. Therefore, EPA may transform "dysfunctional HDL" to "functional", in patients with coronary risk factors" - See fish oil supplements at Amazon.com.
• Effects of Dietary Components on HDL Measures - Medscape, 11/26/14 - "Dietary folate intake was positively associated with HDL-C (p = 0.007), HDL-2 (p = 0.0011), HDL-3 (p = 0.0022), and apoA1 (p = 0.001). Alcohol intake and myristic acid (14:0), a saturated fat, were each significantly associated with increased levels of all HDL-related measures studied. Dietary carbohydrate and iron intake were significantly associated with decreased levels of all HDL-related measures. Magnesium intake was positively associated with HDL-C, HDL-2, and HDL-3 levels, but not apoA1 levels, while vitamin C was only associated with apoA1 levels. Dietary fiber and protein intake were both associated with HDL-3 levels alone"
• Lipid-Lowering Effects of Curcumin in Patients with Metabolic Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial - Phytother Res. 2014 Aug 6 - "Sixty-five patients were randomized into two groups; 33 patients taking curcumin extract capsule (630 mg thrice daily) and 32 patients taking a placebo capsule thrice daily for 12 weeks. At 12 weeks after the curcumin extract consumption, the level of high-density lipoprotein cholesterol (HDL-C) significantly increased from 40.96 ± 8.59 to 43.76 ± 2.79 mg/dL (p < 0.05), and the level of low-density lipoprotein cholesterol (LDL) was significantly reduced (120.55 ± 36.81 to 106.51 ± 25.02 mg/dL, p < 0.05). The triglyceride-lowering effect, a reduction of 65 mg/dL, was also found in this study" - See curcumin products at Amazon.com.
• Vitamin D Insufficiency and Abnormal Hemoglobin A1c in Black and White Older Persons - J Gerontol A Biol Sci Med Sci. 2014 Aug 11 - "2,193 persons of age 70-79 years at Year 1 ... vitamin D insufficiency was associated with an increased likelihood of having abnormal A1c (odds ratio = 1.56; 95% CI: 1.03-2.37)" - See vitamin D at Amazon.com.
• Vitamin D deficiency among the elderly: insights from Qatar - Curr Med Res Opin. 2014 Mar 13 - "A high prevalence of VitD deficiency (72%) was observed among the elderly in Qatar. Lower VitD was associated with higher HbA1c and lower HDL-C levels" - See vitamin D at Amazon.com.
• Fatty-Fish Consumption Alters HDL-Particle Profile - Medscape, 3/7/14 - "Although total-, LDL-, and HDL-cholesterol levels did not change, for those who consumed this healthy diet rich in polyunsaturated fatty acids, the intake of fish was strongly correlated with an increased concentration of large HDL particles, including an increase in the average diameter of HDL particles and an increase in the concentrations of large HDL lipid components ... The changes that we saw in large HDL particles could be related to those parameters that are functionally related to reverse cholesterol transport ... Thus, our findings could partly explain the known protective effects of fish consumption against atherosclerosis" - See fish oil supplements at Amazon.com.
• A Low-Fat, Plant-Based Lifestyle and Serum HDL Levels - Medscape, 12/4/13 - "HDL levels decreased by 8.7% (p<0.001) despite significant reductions (p<0.001) in BMI (-3.2%), systolic BP (-5.2%), diastolic BP (-5.2%), triglycerides (TG; -7.7%), FPG (-6.3%), LDL (-13.0%), total cholesterol (TC, -11.1%), TC: HDL ratio (-3.2%), and LDL: HDL ratio (-5.3%). While 323 participants classified as having MetS at program entry no longer had this status after the 30 days, 112 participants acquired the MetS classification as a result of reduction in their HDL levels"
• Anthocyanin supplementation improves HDL-associated paraoxonase 1 activity and enhances cholesterol efflux capacity in subjects with hypercholesterolemia - J Clin Endocrinol Metab. 2013 Nov 27 - "Paraoxonase 1 (PON1), an enzyme associated with high-density lipoprotein (HDL-PON1), is reported to have antioxidant and cardioprotective properties ... A total of 122 hypercholesterolemic subjects were given 160 mg of anthocyanins twice daily or placebo (n = 61 of each group) for 24 wk in a double-blind, randomized, placebo-controlled trial ... Anthocyanin consumption significantly increased HDL cholesterol and decreased LDL cholesterol concentrations compared with placebo (P < 0.018 and P<0.001, respectively). Anthocyanin supplementation also increased the activity of HDL-PON1 compared with placebo (P<0.001)" - See anthocyanin at Amazon.com.
  • Anthocyanin - Wikipedia, the free encyclopedia - "Anthocyanins ... are water-soluble vacuolar pigments that may appear red, purple, or blue depending on the pH. They belong to a parent class of molecules called flavonoids synthesized via the phenylpropanoid pathway; they are odorless and nearly flavorless, contributing to taste as a moderately astringent sensation ... Plants rich in anthocyanins are Vaccinium species, such as blueberry, cranberry, and bilberry; Rubus berries, including black raspberry, red raspberry, and blackberry; blackcurrant, cherry, eggplant peel, black rice, Concord grape, muscadine grape, red cabbage, and violet petals" - See Garden of Life, Radical Fruits Antioxidant Complex at Amazon.com.

• Blood lipids profile in hyperlipidemic children undergoing different dietary long chain polyunsaturated supplementations: a preliminary clinical trial - Int J Food Sci Nutr. 2013 Nov 14 - "Thirty-six children (8-13 years) were recruited. After an 8-week stabilization period on the Step I diet, they were randomized to additionally receive for a 16-week period one capsule (500 mg) daily of docosahexaenoic acid (DHA) alone or a DHA plus eicosapentaenoic acid (EPA) mixture (45.6% DHA; 41.6% EPA) or wheat germ oil (control). An effect size (as percentage change from baseline) of +8%, -12% and -16% for high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C ratio and triglycerides was observed in children supplemented with DHA, compared to +2%, -8% and -12%, respectively, in children supplemented with DHA plus EPA" - See Jarrow Max DHA at Amazon.com.  Here it is in table form which is easier to see:

  	DHA	DHA + EPA
  HDL	+8%	+2
  Total cholesterol/HDL	-12%	-8%
  Triglycerides	-16%	-12%

• Modulation of human postprandial lipemia by changing ratios of polyunsaturated to saturated (P/S) fatty acid content of blended dietary fats: a cross-over design with repeated measures - Nutr J. 2013 Aug 16;12(1):122 - "This human postprandial study evaluated 3 edible fat blends with differing polyunsaturated to saturated fatty acids (P/S) ratios (POL = 0.27, AHA = 1.00, PCAN = 1.32) ... Varying P/S ratios of test meals significantly altered prandial high density lipoprotein-cholesterol (HDL-C) concentrations (P < 0.001) which increased with decreasing P/S ratio (POL > AHA > PCAN)"
• Genistein in the Metabolic Syndrome: Results of a Randomized Clinical Trial - J Clin Endocrinol Metab. 2013 Jul 3 - "Patients included 120 postmenopausal women with MetS ... postmenopausal women with MetS were randomly assigned to receive placebo (n = 60) or 54 mg genistein daily (n = 60) for 1 year ... At 1 year in genistein recipients, fasting glucose, fasting insulin, and HOMA-IR (mean from 4.5 to 2.7; P < .001) decreased and were unchanged in placebo recipients. Genistein statistically increased HDL-C (mean from 46.4 to 56.8 mg/dL) and adiponectin and decreased total cholesterol, LDL-C (mean from 108.8 to 78.7 mg/dL), triglycerides, visfatin, and homocysteine (mean from 14.3 to 11.7) blood levels. Systolic and diastolic blood pressure was also reduced in genistein recipients. Genistein recipients neither experienced more side adverse effects than placebo nor discontinued the study" - See genistein at Amazon.com.
• Extra-virgin olive oil consumption reduces the age-related decrease in HDL and paraoxonase 1 anti-inflammatory activities - Br J Nutr. 2013 Mar 19:1-13 - "EVOO consumption increased the anti-inflammatory effect of HDL and reduced the age-related decrease in anti-atherogenic activity" - See olive leaf extract at Amazon.com.
• Effect of the consumption of a new symbiotic shake on glycemia and cholesterol levels in elderly people with type 2 diabetes mellitus - Lipids Health Dis. 2012 Feb 22;11:29 - "A randomized, double-blind, placebo-controlled study was conducted on twenty volunteers (ten for placebo group and ten for symbiotic group), aged 50 to 60 years ... Over a total test period of 30 days, 10 individuals (the symbiotic group) consumed a daily dose of 200 mL of a symbiotic shake containing 10(8) UFC/mL Lactobacillus acidophilus, 10(8) UFC/mL Bifidobacterium bifidum and 2 g oligofructose, while 10 other volunteers (the placebo group) drank daily the same amount of a shake that did not contain any symbiotic bacteria ... The results of the symbiotic group showed a non-significant reduction (P > 0.05) in total cholesterol and triglycerides, a significant increase (P < 0.05) in HDL cholesterol and a significant reduction (P < 0.05) in fasting glycemia. No significant changes were observed in the placebo group"
• Beneficial effects of artichoke leaf extract supplementation on increasing HDL-cholesterol in subjects with primary mild hypercholesterolaemia: a double-blind, randomized, placebo-controlled trial - Int J Food Sci Nutr. 2012 Jun 29 - "The aim of this study was to evaluate the effects of artichoke leaf extract (ALE) supplementation (250 mg, 2 b.i.d.) on the lipid pattern. A randomized, double-blind, placebo-controlled clinical trial was performed on 92 overweight subjects with primary mild hypercholesterolaemia for 8 weeks. Forty-six subjects were randomized to supplementation (age: 54.2 +/- 6.6 years, body mass index (BMI): 25.8 +/- 3.9 kg/m(2), male/female: 20/26) and 46 subjects to placebo (age: 53.8 +/- 9.0 years, BMI: 24.8 +/- 1.6 kg/m(2), male/female: 21/25). Verum supplementation was associated with a significant increase in mean high-density lipoprotein (HDL)-cholesterol (p < 0.001) and in mean change in HDL-cholesterol (HDL-C) (p = 0.004). A significantly decreased difference was also found for the mean change in total cholesterol (p = 0.033), low-density lipoprotein (LDL)-cholesterol (p < 0.001), total cholesterol/HDL ratio (p < 0.001) and LDL/HDL ratio (p < 0.001), when verum and placebo treatment were compared. These results indicate that ALE could play a relevant role in the management of mild hypercholesterolaemia, favouring in particular the increase in HDL-C, besides decreasing total cholesterol and LDL-cholesterol" - See artichoke products at iHerb.
• Pomegranate Juice Lowers Cardiovascular Risk Factors - Medscape, 11/12/11 - "HDL rose significantly (P = .005) in the juice group" - See pomegranate at Amazon.com.
• Effect of soy and milk protein supplementation on serum lipid levels: a randomized controlled trial - Eur J Clin Nutr. 2011 Sep 28 - "Previous clinical trials have documented that soy protein reduces low-density lipoprotein cholesterol and increases high-density lipoprotein (HDL) cholesterol compared with milk protein ... Compared with carbohydrate, soy protein supplementation was significantly associated with a net change (95% confidence interval (CI)) in total cholesterol and total/HDL cholesterol ratio of -3.97 mg/dl (-7.63 to -0.31, P=0.03) and -0.12 (-0.23 to -0.01, P=0.03), respectively. Compared with milk protein, soy protein supplementation was significantly associated with a net change (95% CI) in HDL and total/HDL cholesterol ratio of 1.54 mg/dl (0.63 to 2.44, P=0.0009) and -0.14 (-0.22 to -0.05, P=0.001), respectively. Compared with carbohydrate, milk protein supplementation was significantly associated with a net change (95% CI) in HDL of -1.13 mg/dl (-2.05 to -0.22, P=0.02). Conclusions: This randomized controlled trial indicates that soy protein, but not milk protein, supplementation improves the lipid profile among healthy individuals"
• Effects of Diet on High-Density Lipoprotein Cholesterol - Curr Atheroscler Rep. 2011 Sep 8 - "Multiple dietary factors have been shown to increase high-density lipoprotein cholesterol (HDL-C) concentrations, and HDL-C has been inversely associated with coronary heart disease (CHD) risk. Replacement of dietary carbohydrate with polyunsaturated, monounsaturated and saturated fat has been associated with progressively greater increases in HDL-C (7-12%) in addition to other lipid changes. Added sugars, but not high glycemic carbohydrates, have been associated with decreased HDL-C. Alcohol consumption has been associated with increased HDL-C (9.2%) independent of changes in other measured lipids. Modest effects on HDL-C (~4-5%) among other lipid and non-lipid CHD risk factors have also been observed with weight loss by dieting, omega-3 fatty acids, and a Mediterranean diet pattern. The CHD benefit of increasing HDL-C is unclear given the inconsistent evidence from HDL-raising pharmacologic trials. Furthermore, pleiotropic effects of diet preclude attribution of CHD benefit specifically to HDL-C"
• Vitamin E tocotrienols show cholesterol benefits for healthy adults: Study - Nutra USA, 6/29/11 - "Daily supplements of a palm oil-based tocotrienol-rich product increased the ratio of HDL cholesterol to total cholesterol – reported to be the most specific lipid risk factor for cardiovascular disease (CVD) – by 14 percent in people over 50, compared to a decrease of about 5 percent in the placebo group ... HDL cholesterol increases of the magnitude observed in this study have been associated with a 22.5 percent reduced risk of cardiovascular events" - [Abstract] - See Jarrow FamilE (contains all eight members of the vitamin E family, includes Tocomin) at Amazon.com.
• Serum 25-hydroxyvitamin D levels and the metabolic syndrome in older persons. A population-based study - Clin Endocrinol (Oxf). 2011 May 20 - "Among the participants, the prevalence of the metabolic syndrome was 37.0%. The mean 25OHD level was 53.3 nmol/l. 47.8% had 25OHD levels below 50 nmol/l. There was a significantly increased risk for the metabolic syndrome in the subjects with serum 25OHD levels below 50 nmol/l, compared to subjects with levels over 50 nmol/l [odds ratio (OR)=1.54; 95% confidence interval (CI) 1.23-1.94]. After adjustment for confounders, age, sex, season, years of education, alcohol use, total activity, smoking and PTH the OR was 1.29 (95% CI 1.00-1.68). The association between vitamin D deficiency and the metabolic syndrome was mainly determined by the components low HDL and (high) waist circumference" - See vitamin D at Amazon.com.
• Identification of a mechanism for increased cardiovascular risk among individuals with low vitamin D concentrations - Menopause. 2011 May 17 - "Plasma vitamin D3 concentration was positively associated with high-density lipoprotein cholesterol (HDL-C; P = 0.003). Monkeys in the high vitamin D3 group had a significantly greater plasma HDL-C concentration (57.9 mg/dL) than did those in the low vitamin D3 group (47.1 mg/dL; P = 0.001). Although the difference was not significant (P = 0.120), the monkeys in the high vitamin D3 group had a decreased total plasma cholesterol-to-HDL-C ratio compared with those in the low vitamin D3 group (5.4 and 6.2, respectively), potentially putting them at lower risk of atherosclerosis development" - See vitamin D at Amazon.com.
• Niacin results in reduced monocyte adhesion in patients with type 2 diabetes mellitus - Atherosclerosis. 2010 Dec 25 - "Patients with type 2 diabetes have increased expression of cell adhesion molecules (CAMs). CAMs and monocyte adhesion mediate essential processes in atherogenesis ... Niacin 1500mg daily raised HDL-cholesterol from 0.8mmol/l (95% CI: 0.7-0.9) to 0.9mmol/l (95% CI: 0.8-1.1), p=0.10, and significantly reduced PECAM-1 by 24.9% (95% CI: 10.9-39.0; p<0.05), increased adiponectin by 30.5% (95% CI: 14.1-47.0; p<0.05), with monocyte adhesion reduced by 9.2% (95%CI: 0.7-17.7; p<0.05) in endothelial cells treated in basal conditions, and 7.8% (95% CI: 3.1-12.5; p<0.05) after TNF-α stimulation ... Monocytes isolated from patients on niacin had reduced adhesion to endothelial cells. Our findings suggest niacin has broad range of effects apart from lipid-modification, and these could be important in cardiovascular risk reduction" - See niacin at Amazon.com.
• Orange juice decreases low-density lipoprotein cholesterol in hypercholesterolemic subjects and improves lipid transfer to high-density lipoprotein in normal and hypercholesterolemic subjects - Nutr Res. 2010 Oct;30(10):689-94 - "normolipidemic (NC) and hypercholesterolemic (HCH) subjects ... consumed 750 mL/day OJ concentrate (1:6 OJ/water) for 60 days ... Orange juice consumption decreased low-density lipoprotein cholesterol (160 +/- 17 to 141 +/- 26 mg/dL, P < .01) in the HCH group but not in the NC group. HDL-cholesterol and triglycerides remained unchanged in both groups. Free-cholesterol transfer to HDL increased (HCH: 4.4 +/- 2 to 5.6 +/- 1%, NC: 3.2 +/- 2 to 6.2 +/- 1%, P< .05) whereas triglyceride (HCH 4.9 +/- 1 to 3.1 +/- 1%, NC 4.4 +/- 1 to 3.4 +/- 1%, P< .05) and phospholipid (HCH 21.6 +/- 2 to 18.6 +/- 3%, NC 20.2 +/- 2 to 18.4 +/- 2%, P < .05) transfers decreased in both groups. Cholesteryl-ester transfer decreased only in HCH (3.6 +/- 1 to 3.1 +/- 1%, P < .05), but not in NC" - Note:  750 ml is .79 quarts.  Seem like it might be a problem with weight gain.
• High-cocoa polyphenol-rich chocolate improves HDL cholesterol in Type 2 diabetes patients - Diabet Med. 2010 Nov;27(11):1318-21 - "Subjects were randomized to 45 g chocolate with or without a high polyphenol content for 8 weeks and then crossed over after a 4-week washout period ... HDL cholesterol increased significantly with high polyphenol chocolate (1.16 +/- 0.08 vs. 1.26 +/- 0.08 mmol/l, P = 0.05) with a decrease in the total cholesterol: HDL ratio (4.4 +/- 0.4 vs. 4.1 +/- 0.4 mmol/l, P = 0.04). No changes were seen with the low polyphenol chocolate in any parameters. Over the course of 16 weeks of daily chocolate consumption neither weight nor glycaemic control altered from baseline" - The Lindt - Excellence 90% Cocoa Bar are 3.5 ounces or 99 grams or about 90 grams of chocolate.  So 45 grams would be half a bar per day.
• Effects of myo-inositol supplementation in postmenopausal women with metabolic syndrome: a perspective, randomized, placebo-controlled study - Menopause. 2010 Aug 31 - "Myo-inositol plus diet improved systolic and diastolic blood pressure, HOMA index, cholesterol, and triglyceride serum levels with highly significant differences, compared with the groups treated only with diet and placebo. In the group treated with myo-inositol, a decrease in diastolic blood pressure (-11%), HOMA index (-75%), and serum triglycerides (-20%) and an improvement in high-density lipoprotein cholesterol (22%) were shown ... CONCLUSIONS: Supplementation with myo-inositol may be considered a reliable option in the treatment of metabolic syndrome in postmenopausal women" - Note:  See raysahelian.com/inositol.html  and http://en.wikipedia.org/wiki/Inositol which claim myo-inositol and inositol are the same.  See inositol products at iHerb.
• Astaxanthin’s heart benefits get human data support - Nutra USA, 8/9/10 - "Daily supplements of the carotenoid astaxanthin may improve HDL ‘good’ cholesterol levels in people with mildly abnormal blood lipid levels ... participants receiving the two highest doses experienced significant reductions in their triglyceride levels, of 25 and 24 percent, respectively, compared to baseline. Furthermore, people receiving 6 or 12 mg per day experienced significant increases in their HDL-cholesterol levels of 10 and 15 percent, respectively ... Additionally, adiponectin levels increased in the two highest dose groups, with increases over 20 percent in the 12 mg per day group, and between 15 and 20 percent in the 18 percent group" - See Jarrow Formulas, CarotenALL, Mixed Carotenoid Complex at Amazon.comor astaxanthin products at iHerb.
• Administration of natural astaxanthin increases serum HDL-cholesterol and adiponectin in subjects with mild hyperlipidemia - Atherosclerosis. 2010 Apr;209(2):520-3 - "Multiple comparison tests showed that 12 and 18 mg/day doses significantly reduced triglyceride, and 6 and 12 mg doses significantly increased HDL-cholesterol. Serum adiponectin was increased by astaxanthin (12 and 18 mg/day), and changes of adiponectin correlated positively with HDL-cholesterol changes independent of age and BMI" - See Jarrow Formulas, CarotenALL, Mixed Carotenoid Complex at Amazon.comor astaxanthin products at iHerb.
• HDL Cholesterol and Cancer - Medscape, 6/15/10 - "even after adjustment for multiple variables, there was a 36% lower risk of cancer for every 10-mg/dL increase in HDL cholesterol" - See niacin at Amazon.com.
• Endothelial-Vasoprotective Effects of High-Density Lipoprotein Are Impaired in Patients With Type 2 Diabetes Mellitus but Are Improved After Extended-Release Niacin Therapy - Circulation. 2009 Dec 21 - "Patients with diabetes were randomized to a 3-month therapy with ER niacin (1500 mg/d) or placebo ... HDL from healthy subjects stimulated endothelial nitric oxide production, reduced endothelial oxidant stress, and improved endothelium-dependent vasodilation and early endothelial progenitor cell-mediated endothelial repair. In contrast, these beneficial endothelial effects of HDL were not observed in HDL from diabetic patients, which suggests markedly impaired endothelial-protective properties of HDL. ER niacin therapy improved the capacity of HDL to stimulate endothelial nitric oxide, to reduce superoxide production, and to promote endothelial progenitor cell-mediated endothelial repair. Further measurements suggested increased lipid oxidation of HDL in diabetic patients, and a reduction after ER niacin therapy ... HDL from patients with type 2 diabetes mellitus and metabolic syndrome has substantially impaired endothelial-protective effects compared with HDL from healthy subjects. ER niacin therapy not only increases HDL plasma levels but markedly improves endothelial-protective functions of HDL in these patients, which is potentially more important" - See niacin at Amazon.com.
• Niacin Tops Zetia in Cutting Artery Plaque - WebMD, 11/16/09 - "The question is whether ezetimibe works at all ... Niacin has been around for 50 years. It's a well-understood drug, and in this trial it was clearly superior ... Ultrasound images of neck arteries showed that Niaspan reduced artery plaque by about 2%. Zetia did not slow plaque buildup, although it did lower cholesterol" - See niacin at Amazon.com.
• ARBITER 6-HALTS: HDL Raising With Niacin Superior to Ezetimibe - Medscape, 11/16/09 - "Adding extended-release niacin (Niaspan, Abbott) to statin therapy results in a significant regression of atherosclerosis as measured by carotid intima-media thickness (IMT), whereas the addition of ezetimibe (Zetia, Merck/Schering-Plough) to statin therapy did not, according to an eagerly anticipated study" - See niacin at Amazon.com.
• Raising 'Good' Cholesterol Levels May Benefit Clogged Arteries - Science Daily, 11/6/09 - "Using MRI scans, we have shown a reduction in the size of artery walls in patients after a year of treatment with nicotinic acid ... Nicotinic acid, sometimes known as niacin, is one of the oldest drugs used for atherosclerosis and only fell out of favour as statins came to prominence. It is known to raise levels of good cholesterol in the blood" - See niacin at Amazon.com.
• Low HDL Levels as the Most Common Metabolic Syndrome Risk Factor in Heart Failure - Int Heart J. 2009 Sep;50(5):571-80 - "The most prevalent parameters were low HDL-C (69%) and hypertension (69%) in all participants" -  Note:  The best way to raise HDL is with niacin.  The no flush form doesn't work and the slow release may cause liver damage.  People complain about the flush but I've been taking it for years and the longer you take it the less flush.  After a while, there is no flush at all but be sure to take it with food.  http://www.lipidsonline.org/slides/slide01.cfm?tk=25&dpg=34 shows that with extended release niacin, HDL peaks out at 2,500 mg.  http://www.lipidsonline.org/slides/slide01.cfm?q=effect+of+niacin&dpg=4 shows immediate release crystalline niacin compared to Niaspan.  The numbers are basically the same.  I don't see any point in the prescription other than that it might have less flushing when you first start taking it.  See niacin at Amazon.com.
• Anthocyanin supplementation improves serum LDL- and HDL-cholesterol concentrations associated with the inhibition of cholesteryl ester transfer protein in dyslipidemic subjects - Am J Clin Nutr. 2009 Jul 29 - "Anthocyanin consumption increased HDL-cholesterol concentrations (13.7% and 2.8% in the anthocyanin and placebo groups, respectively; P < 0.001) and decreased LDL-cholesterol concentrations (13.6% and -0.6% in the anthocyanin and placebo groups, respectively; P < 0.001). The cellular cholesterol efflux to serum increased more in the anthocyanin group than in the placebo group (20.0% and 0.2%, respectively; P < 0.001). Anthocyanin supplementation decreased the mass and activity of plasma cholesteryl ester transfer protein (CETP) (10.4% and 6.3% in the anthocyanin group and -3.5% and 1.1% in the placebo group, respectively; P < 0.001)" - See blueberry extract at Amazon.com and bilberry at Amazon.com.
• Biology Of Flushing Could Renew Niacin As Cholesterol Drug - Science Daily, 4/6/09 - "Niacin, also known as nicotinic acid or vitamin B3, has long been regarded as one of the most effective weapons in managing cholesterol. It can lower levels of triglycerides, fatty acids and to a lesser extent, the "bad" kind of cholesterol (LDL) while at the same time powerfully increasing the "good" kind (HDL). But there's a catch – a big one. Patients don't like to take niacin because in most of them, it causes embarrassing, uncontrollable intense flushing, a rush of blood to the face and other skin surfaces accompanied by a prickling sensation ... One particular protein in that group, beta-arrestin1, was found to trigger the chemical reaction that led to flushing ... beta-arrestin1 plays no role whatsoever in niacin's ability to lower cholesterol and fatty acids ... the discovery opens the door to the possibility of developing a "biased ligand," a drug that would trigger GP109A, but not the beta-arrestins"
• An oily fish diet increases insulin sensitivity compared to a red meat diet in young iron-deficient women - Br J Nutr. 2009 Feb 12:1-8 - "Insulin levels significantly decreased and insulin sensitivity significantly increased with the oily fish diet. HDL-cholesterol significantly increased with the oily fish diet" - See Mega Twin EPA at Amazon.com and Jarrow Max DHA at Amazon.com.
• Effect of cranberry extracts on lipid profiles in subjects with Type 2 diabetes - Diabet Med. 2008 Dec;25(12):1473-7 - "Changes in lipid profiles, oxidized low-density lipoprotein (ox-LDL), glycaemic control, components of the metabolic syndrome, C-reactive protein (CRP) and urinary albumin excretion (UAE) were assessed after cranberry or placebo treatment for 12 weeks ... Low-density lipoprotein (LDL) cholesterol decreased significantly in the cranberry group (from 3.3 +/- 0.2 to 2.9 +/- 0.2 mmol/l, P = 0.005) and the decrease was significantly greater than that in the placebo group (-0.4 +/- 0.1 vs. 0.2 +/- 0.1 mmol/l, P < 0.001). Total cholesterol and total : high-density lipoprotein (HDL) cholesterol ratio also decreased significantly (P = 0.020 and 0.044, respectively) in the cranberry group and the reductions were significantly different from those in the placebo group (P < 0.001 and P = 0.032, respectively) ... Cranberry supplements are effective in reducing atherosclerotic cholesterol profiles, including LDL cholesterol and total cholesterol levels, as well as total : HDL cholesterol ratio, and have a neutral effect on glycaemic control in Type 2 diabetic subjects taking oral glucose-lowering agents" - See cranberry extract at Amazon.com.
• Long-term effects of resveratrol supplementation on suppression of atherogenic lesion formation and cholesterol synthesis in apo E-deficient mice - Biochem Biophys Res Commun. 2008 Jul 5 - "The concentration of total-cholesterol (total-C) and LDL-cholesterol (LDL-C) in plasma was significantly lower in the resveratrol-supplemented groups compare to the control group over the entire experimental period. The plasma HDL-C concentration was significantly elevated, and the ratio of HDL-C/total-C was significantly higher in the CF and RV groups than in the control group. Plasma paraoxonase (PON) activity was significantly higher in the 0.06% resveratrol group. The hepatic HMG-CoA reductase (HMGR) activity was significantly lower in the clofibrate and resveratrol groups than in the control group. Resveratrol supplements attenuated the presence of atherosclerotic lesions and periarterial fat deposition in the apo E(-/-) mice. The presence of intracellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in atherosclerotic vessels was diminished in the resveratrol-supplemented apo E(-/-) mice. These results provide new insight into the anti-atherogenic and hypocholesterolemic properties of resveratrol in apo E(-/-) mice that were fed a normal diet" - See resveratrol products at Amazon.com.
• HDL Cholesterol Linked to Lower Extremity Performance in Elderly - Medscape, 5/2/08 - "HDL-C levels were significantly associated with all indices of function ... participants with the highest HDL-C levels having the best physical performance"
• Combination Niacin-Laropiprant Plus Simvastatin Reduces Cholesterol by Almost 50% - Doctor's Guide, 11/6/07 - "When patients with dyslipidemia added simvastatin to their experimental combination of extended-release niacin and laropiprant -- a novel anti-flushing agent -- they reported reductions in low density lipoprotein cholesterol (LDL-C) of as much as 48% from baseline ... high density liopoprotein cholesterol (HDL-C) was increased by 28% and triglycerides decreased by 33%"
• The effects of extended-release niacin on carotid intimal media thickness, endothelial function and inflammatory markers in patients with the metabolic syndrome - Int J Clin Pract. 2007 Nov;61(11):1942-8 - "After 52 weeks of treatment, there was a change of carotid IMT of +0.009 +/- 0.003 mm in the placebo group and -0.005 +/- 0.002 mm in the niacin group (p = 0.021 between groups). Endothelial function improved by 22% in the group treated with niacin (p < 0.001), whereas no significant changes were seen in the placebo group. High sensitivity C-reactive protein decreased by 20% in the group treated with niacin for 52 weeks (p = 0.013). Niacin increased HDL-C (p < 0.001) and decreased low-density lipoprotein cholesterol and triglycerides (p < 0.001) significantly, and there were no adverse effects on fasting glucose levels after 52 weeks of treatment" - See niacin at Amazon.com or niacin at Amazon.com.
• Dietary glycemic index and glycemic load are associated with high-density-lipoprotein cholesterol at baseline but not with increased risk of diabetes in the Whitehall II study - Am J Clin Nutr. 2007 Oct;86(4):988-994 - "At baseline, dietary GI and GL were associated inversely with HDL cholesterol, and GI was associated directly with triacylglycerols. Dietary GI and GL were related inversely to fasting glucose and directly to 2-h postload glucose ... The proposed protective effect of low-dietary GI and GL diets on diabetes risk could not be confirmed in this study"
• Vitamin E dietary supplementation significantly affects multiple risk factors for cardiovascular disease in baboons - Am J Clin Nutr. 2007 Sep;86(3):597-603 - "vitamin E caused 2 paradoxical effects on HDL metabolism: higher apolipoprotein A-I (apo A-I) concentrations and lower HDL sizes ... They also show 2 apparently paradoxical effects on HDL metabolism: lower HDL(2), which is mediated by genes, and higher apo A-I, which is not. These effects have contrasting associations with CVD risk and may help account for the mixed results from clinical trials of dietary vitamin E"
• Niacin (Nicotinic Acid) -- The Old Drug Is Making a Comeback With A New Act - Medscape, 6/11/07 - "Niacin (nicotinic acid) is well known as the most effective drug currently available for raising levels of high-density lipoprotein (HDL) cholesterol, raising it by 25% to 35% at the highest doses"
• Exercise May Boost 'Good' Cholesterol - WebMD, 5/29/07 - "Participants who got at least two hours per week of aerobic exercise had a modest rise in their HDL cholesterol level ... the gains in HDL cholesterol levels translate to a 5% drop in men's heart disease risk and more than a 7% drop in women's heart disease risk"
• Continuous intake of polyphenolic compounds containing cocoa powder reduces LDL oxidative susceptibility and has beneficial effects on plasma HDL-cholesterol concentrations in humans - Am J Clin Nutr. 2007 Mar;85(3):709-17 - "A significantly greater increase in plasma HDL cholesterol (24%) was observed in the cocoa group than in the control group (5%)"
• An Old Cholesterol Remedy Is New Again - New York Times, 1/23/07 - "In its therapeutic form, nicotinic acid, niacin can increase HDL as much as 35 percent when taken in high doses, usually about 2,000 milligrams per day. It also lowers LDL, though not as sharply as statins do, and it has been shown to reduce serum levels of artery-clogging triglycerides as much as 50 percent ... There’s a great unfilled need for something that raises HDL ... Right now, in the wake of the failure of torcetrapib, niacin is really it. Nothing else available is that effective" - See niacin at Amazon.com.
• What is the dietary treatment for low HDL cholesterol? - J Fam Pract. 2006 Dec;55(12):1076-8 - "Low-carbohydrate diets raise high-density lipoprotein (HDL) cholesterol levels by approximately 10%; soy protein with isoflavones raises HDL by 3% ... Dietary Approaches to Stop Hypertension (DASH) diet and multivitamin supplementation raise HDL 21% to 33%"
• Research shows benefits of cranberries -MSNBC, 11/20/06 - "Drinking cranberry juice daily may increase levels of HDL, or good cholesterol and reduce levels of LDL, or bad cholesterol" - See cranberry supplements at Amazon.com.
• Favourable impact of low-calorie cranberry juice consumption on plasma HDL-cholesterol concentrations in men - Br J Nutr. 2006 Aug;96(2):357-64 - "daily CJC consumption is associated with an increase in plasma HDL-cholesterol concentrations in abdominally obese men. We hypothesise that polyphenolic compounds from cranberries may be responsible for this effect, supporting the notion that the consumption of flavonoid-rich foods can be cardioprotective"
• Comparative Effects on Lipid Levels of Niaspan and Statins - Medscape, 7/28/06 - "Niacin is the best HDL-cholesterol raising drug right now"
• About 5% of Long-term Niacin Users Evolve Into HDL Hyperresponders - Doctor's Guide, 3/14/06 - "about 5% of patients on long-term therapy become hyperresponders, increasing their HDL levels by 50% or more ... Overall, these patients lost 4% of body weight while on niacin treatment"
• Fiber Supplements May Lower Cardiovascular Risk In Type 2 Diabetics - Science Daily, 4/30/05 - "Study participants received 10g to 15g of BiosLife 2, an over-the-counter fiber supplement ... total cholesterol had dropped from 215 mg/dL to 184 mg/dL, a 14.4 percent decrease. Triglycerides also improved, dropping from 299 mg/dL to 257 mg/dL, a 14 percent decrease ... LDL decreased from 129 mg/dL to 92 mg/dL -- a 28.7 percent improvement. HDL rose from 43 mg/dL to 55 mg/dL -- a 21.8 percent increase"
• The Effects of Niacin on Lipoprotein Subclass Distribution - Medscape, 1/19/05 - "the combination of niacin and a statin may be among the best available treatment options for many patients with complex forms of dyslipidemia ... Niacin effectively modifies all major lipids and lipoproteins with respect to both their quantity and quality. It is the most effective agent currently available for raising low levels of HDL cholesterol"
• Grape Juice Raises 'Good' Cholesterol Levels - WebMD, 11/19/04 - "Grape juice drinkers had HDL levels of 50 mg/dL, compared with almost 45 mg/dL in the placebo group"
• Raising HDL in Clinical Practice - Medscape, 6/10/04 - "Niacin increases HDL-C to the greatest extent of all available monotherapies: by 15% to 35% at higher daily doses on the order of 3 grams ... Capsules containing omega-3 fatty acids (1.48 g of docosahexaenoic acid + 1.88 g of eicosapentaenoic acid) have been formulated and are commercially available in some parts of the world (as Omacor). In a recent small study in patients with familial combined hyperlipidemia, treatment with this formulation for 8 weeks increased HDL-C by 8%"
• Dietary supplementation with olive oil leads to improved lipoprotein spectrum and lower n-6 PUFAs in elderly subjects - Med Sci Monit. 2004 Mar 23;10(4):PI49-PI54 - "The supplement was taken for 6 weeks and involved daily consumption of 2 tablespoons ... There was also a significant decline in the total-to-HDL and LDL-to-HDL cholesterol ratios" - I alternate between Smart Balance Omega-Plus (made with omega-3 fish oil) and Fleischmann's Olive Oil spread.
• HDL: The "Quit" Cholesterol - Physician's Weekly, 2/23/04 - "for every 1 mg/dL increase in HDL, risk for a CAD event is reduced by 2% in men and 3% in women ... It hasn't gotten the same attention as LDL partly because there haven't been good medicines for raising it ... Niacin is, according to Dr. Rader, “…the best HDL-raising agent currently available.”"
• Scientists Eye Pills To Unclog Arteries - Intelihealth, 2/2/04 - "HDL scoops up cholesterol from the arteries and carries it back to the liver for disposal ... men's average HDL is about 45 and women's is 55. HDL under 40 is an especially bad sign, while anything over 60 is considered good. Those with HDL over 75 may even be blessed with what's called the "longevity syndrome." ... many specialists recommend more use of the HDL booster already on the market, the vitamin niacin"
• 4 Popular Diets Heart Healthy - WebMD, 11/10/03 - "the heart disease risk score is based on the ratio between LDL cholesterol and HDL "good" cholesterol ... The Atkins and Zone diets increased HDL by 15%, while Weight Watchers posted an 18.5% gain. But the Ornish diet increased HDL by just 2.2%"
• Vitamin C Inhibits Lipid Oxidation in Human HDL - J Nutr. 2003 Oct;133(10):3047-51 - "In the absence of vitamin C, lipid oxidation in HDL began immediately and proceeded rapidly ... Vitamin C (50-200 micro mol/L) retarded initiation of lipid oxidation for at least 4 h under the same conditions ... Our results demonstrate that vitamin C inhibits lipid oxidation in HDL and preserves the antioxidant activity associated with this lipoprotein fraction"
• Vitamin B12 Improves Homocysteine Levels and Lipid Profiles in Patients with End-Stage Renal Disease - Doctor's Guide, 10/6/03 - "During Phase 1, patients were prescribed oral doses of folic acid 5 mg/day and vitamin B12 0.6mg/day. Through out Phase 2, participants were given intravenous doses of vitamin B12 1mg every other day in addition to folic acid 5 mg/day ... By the completion of the study, patients exhibited significantly lower serum tHcy (29.4 verses 21.1 mg/dL), total cholesterol (222 verses 196 mg/dL), and low-density lipoprotein cholesterol levels (139 versus 109 mg/dL). Serum high-density lipoprotein (HDL) cholesterol levels increased significantly among the participants"
• Does High Cholesterol Harm Your Kidneys? - Dr. Weil, 8/22/03 - "apparently healthy men with low HDL (high density lipoprotein), the “good” cholesterol, and high LDL (low density lipoprotein) or “bad” cholesterol and triglycerides have twice the normal risk of reduced kidney function ... You can raise HDL by increasing exercise, drinking alcohol moderately, and eating only healthy fats (monounsaturates such as olive oil and omega-3s from sources like salmon and sardines). Taking prescription statin drugs also will help, although I prefer natural alternatives such as red rice yeast"
• Cholesterol: Finding Right Mix - CBS News, 7/11/03 - "High-density Lipoprotein (HDL) cholesterol is known as the "good" cholesterol. It helps move the bad cholesterol through the body's system to get rid of excess amounts. With enough "good" cholesterol, the "bad" cholesterol doesn't get a chance to build up ... Your total cholesterol should be less than 200. Levels of "good" cholesterol should be below 40. Levels of "bad" cholesterol should be less than 130, or less than 100 if you already have heart disease ... Certain foods such as soy, whole grain oats or fish containing omega-3 fatty acids can lower cholesterol" - I believe that "Levels of "good" cholesterol should be below 40" should be "above" not "below". - Ben
• Policosanol more Effective than Lovastatin for Intermittent Claudication - New Hope Natural Media, 5/29/03 - "Those taking policosanol had a 34% increase in pain-free walking distance, while no change was observed in those taking lovastatin. Quality of life was also reported as being significantly better in the policosanol group compared with the lovastatin group. Both treatment groups had significant reductions in total cholesterol and LDL cholesterol. However, participants taking policosanol had a significant 32% increase in HDL cholesterol and a 6% decrease in fibrinogen, while these parameters remained unchanged in those receiving lovastatin" - See iHerb policosanol products.  Claudication gets my attention because my father has it and if there is a hereditary factor, I want to prevent it. - Ben
• Cranberry Juice Fights Heart Disease - WebMD, 3/24/03 - "Cranberry juice is higher in phenol antioxidants than other fruit juices with the exception of grape juice ... levels of high-density lipoprotein ("good" cholesterol) appeared to increase significantly -- by as much as 121% -- after two or three glasses of juice a day"
• Differential effects of saturated and monounsaturated fats on postprandial lipemia and glucagon-like peptide 1 responses in patients with type 2 diabetes - AJCN, 3/1/03 - "Olive oil induced lower triacylglycerol concentrations and higher HDL-cholesterol concentrations than did butter, without eliciting significant changes in glucose, insulin, or fatty acids" - Olive oil is 76% omega-9.
• Policosanol Improves Lipid Profiles - Natural Foods Merchandiser, 1/03 - "In one eight-week study with 68 older patients who had both elevated LDL levels and various coronary heart disease risk factors, researchers found 10 mg of Cuban policosanol taken once daily reduced (from baseline) LDL levels by 19 percent and triglycerides by 14 percent, and increased HDL levels by 18 percent, all statistically significant changes.26 The statin group (10 mg per day of pravastatin, the lowest dose recommended) triggered a 16 percent reduction in LDL levels, no change in triglycerides, and a 6 percent increase in HDL levels" - See iHerb policosanol products.
• Ispaghula Husk [psyllium] Nearly As Effective As Simvastatin For Hyperlipidemia - Doctor's Guide, 12/24/02 - "One group received 3.5 grams of ispaghula husk twice a day and the second group received 20 milligrams of simvastatin each day ... total cholesterol decreased by 15.8 percent and low-density lipoprotein (LDL) cholesterol decreased by 22.97 percent among patients taking ispaghula husk ... Triglycerides decreased by 20.89 percent and high-density lipoprotein (HDL) cholesterol increased by 10.69 percent in these patients ... Among patients taking simvastatin, total cholesterol decreased by 24.15 percent, LDL cholesterol decreased by 36.08 percent, triglycerides decreased by 20.47 percent and HDL cholesterol increased by 11.4 percent" - I've got that. See psyllium husk at Amazon.com.  3.5 grams is about one wafer (3.4 grams psyllium/wafer).  Plus 24 wafers runs about $4.49 versus about $116 for 30 of the 20 mg simvastatin.
• Eating Yogurt Daily Increases “Good” Cholesterol in Women - New Hope Natural Media, 12/5/02 - "In this study, 29 women ate 300 grams (about 10.6 ounces) of a full-fat (3.5% fat by weight) yogurt product daily for 21 weeks ... A larger, and statistically significant, 38% increase was observed in HDL, or “good” cholesterol levels after eating the yogurt. No change was observed in LDL, or “bad,” cholesterol levels ... each woman also ate the probiotic- and prebiotic-containing product for a 7-week stretch during the 21-week trial. During the period when the women consumed the supplemented yogurt, there was a further increase in HDL cholesterol beyond that seen from simply eating plain yogurt" - See iHerb probiotics products.
• Genes Determine Effect of Diet, Good Cholesterol - WebMD, 10/21/02 - "To increase HDLs, you shouldn't consume more saturated fats. Instead, you should have more monounsaturated fats, which are abundant in many vegetables, oils, and walnuts."
• Alcohol Can Help Women's Hearts Too - WebMD, 9/16/02 - "10 men aged 45-64 and nine women aged 49-62 drank either regular beer or non-alcoholic beer for three weeks ... After 10 days of drinking alcohol, HDL cholesterol levels rose by an average of nearly 7% for both men and women ... Previous research suggests that a 1% increase in HDL cholesterol is linked to a 2% reduction in the risk of heart disease"
• Niacin May Be Effective Therapy For Broad Range Of Diabetes-Associated Dyslipidaemias - Doctor's Guide, 7/25/02 - "After niacin treatment, the patients' LDL peak particle diameter increased from 252 +/- 7 Å to 263 +/- 7, the researchers reported. Their small, dense LDLc particle mass decreased from 27 +/- 11 mg/dL to 15 +/- 4 mg/dL. Total HDLc increased from 39 +/- 7 mg/dL to 51 +/- 11 mg/dL. Their HDL2, as the percentage of total HDLc mass, increased from 29 +/- 8 percent to 45 +/- 10 percent, and their Lp(a) decreased from 43 +/- 17 mg/dL to 25 +/- 10 mg/dL ... Twenty-one percent of the patients were unable to tolerate niacin because of reversible adverse effects. Another 14 percent were unable to adhere to the niacin dosing regimen of three times daily"
• HDL Too High? - Dr. Weil, 6/6/02 - "each increase of 4 mg/dl in the HDL level results in a 10 percent decrease in risk of adverse coronary events"
• Policosanol Helps Reduce High Cholesterol - New Hope Natural Media, 6/6/02 - "In a six-month study, 10 mg per day of policosanol reduced total cholesterol by 16% and LDL cholesterol by 24%, and increased HDL cholesterol by 29%. Several other studies have compared policosanol with some of the conventional medications used for lowering cholesterol and the results have shown policosanol in the amount of 5 to 20 mg per day to be more effective than lovastatin (Mevacor®), pravastatin (Pravachol®), and simvastatin (Zocor®), with fewer reported side effects. While some prescription drugs used to lower cholesterol may cause liver and muscle problems in rare instances, people taking policosanol have not suffered any serious side effects" - See iHerb policosanol products.
• Health Benefits of Olive Oil - California Olive Oil Council - "Olive oil is 80% oleic acid, placing it at the top of the list of monounsaturated fats ... Research has proved that using olive oil significantly increases HDL levels"
• Octacosanol Beats Statins - Dr. Janson, 4/02 - "Taking a non-flush form of niacin, inositol hexaniacinate, provides the same cholesterol effects without the liver changes, but it is more expensive. Effective niacin doses are 1500 to 3000 mg daily"
• Men's Fitness: Boost your good cholesterol sky-high: want to live longer? Try raising this cholesterol with our 10 strategies - findarticles.com, 2/02 - "In a Canadian study, drinking a few glasses of orange juice every day for four weeks increased participants' HDL by 21 percent, possibly due to a flavonoid called hesperidin that appears extremely HDL-friendly"
• Statins and Supplements - Natural Foods Merchandiser, 1/02
• question regarding your new cholesterol-lowering supplement, Policosanol - Life Extension Magazine, 11/01 - "Studies show that niacin (B3) in doses of 1.5 grams to 3 grams lower triglycerides levels and raise HDL concentrations. Those who tolerated higher doses of niacin (nicotinic acid) showed even more improvement in lipid levels. Some people taking just 1000 mg of flush-free niacin see an elevation in beneficial HDL. Green tea also has been shown to elevate levels of HDL while lowering serum triglyceride levels. In the Journal of Molecular Cell Biochemistry, curcumin has been demonstrated, in vivo, to decrease triglycerides and increase HDL. In a study published in 1989 by the Journal of Associated Physicians-India, 125 patients receiving gugulipid showed a drop of 16.8% in triglycerides, and a 60% increase in HDL cholesterol within three to four weeks. Make sure you are taking at least six Mega EPA fish oil capsules daily, as low dose fish oil may not adequately suppress triglycerides. Finally, there are some lifestyle changes you may wish to consider. If you are overweight, weight loss would be recommended, as it would help to lower triglycerides and raise HDL. Also, try reducing carbohydrates, which can raise triglycerides"
• Product Review: Omega-3 Fatty Acids (EPA and DHA) from Fish/Marine Oils - ConsumerLabs.com, 11/20/01 - "It's been discovered that EPA and DHA may help prevent heart disease and atherosclerosis by lowering triglyceride levels, raising HDL ("good") cholesterol and, possibly "thinning" the blood ... By decreasing inflammation, EPA and DHA can also reduce the pain of rheumatoid arthritis ... Fish oils may also be useful in treating a host of conditions including bipolar (manic-depressive) disorder, Raynaud's phenomenon (abnormal sensitivity of hands and feet to cold), lupus, IgA nephropathy, kidney stones, chronic fatigue syndrome, Crohn's disease, cystic fibrosis, and ulcerative colitis ... EPA specifically may be helpful for schizophrenia, while DHA may be more helpful in reducing high blood pressure ... DHA may be helpful in the treatment of disorders such as attention deficit disorders, dyslexia, and cognitive impairment and dementia ... experts now believe that the American diet contains too little omega-3 fatty acids and too much omega-6 fatty acids"
• Cardiovascular Health - Nutrition Science News, 9/01 - "HDL cholesterol was significantly increased in the intervention [coenzyme Q10] group without affecting total cholesterol or LDL cholesterol"
• An Antioxidant Cocktail May Prove to Be Heart Unhealthy - WebMD, 8/9/01 - "Taken alone the drug combination simvastatin and niacin increased HDL, the so-called good cholesterol by 25%, but when antioxidants were added HDL increased by only 18%"
• A Fish Story - Nutrition Science News, 4/01 - "daily consumption of very low daily doses of EPA/DHA (120 mg/180 mg, about one standard fish oil capsule) in an enriched milk led to a 19 percent decrease in blood triglycerides and a 19 percent increase in HDL cholesterol after six weeks ... It is unclear whether EPA is superior to DHA, although EPA has proven more potent in relaxing cow coronary arteries and producing the vasodilator gas, nitric oxide, in vitro"
• Niacin Reduces Triglycerides, Increases Good Cholesterol In Diabetics - Doctor's Guide, 3/20/01
• Effects of policosanol in older patients with type II hypercholesterolemia and high coronary risk - J Gerontol A Biol Sci Med Sci 2001 Mar;56(3):M186-92 - "while significantly (p é .01) increasing (p < .001) high-density lipoprotein cholesterol (HDL-C) by 14.6% and 29.1%, respectively ... No serious adverse experiences occurred in policosanol patients (p < .01), compared with seven adverse experiences (7.9%) reported by placebo patients"
• Niaspan (Niacin Extended Release Tablets) Safe And Effective For Diabetics - Doctor's Guide, 11/14/00
• Statin Plus Niacin Reduces Heart Attack Risk, Reverses Arterial Build-up - Doctor's Guide, 11/13/00
• Spent Yeast Improves Cholesterol Count - Nutrition Science News, 5/00
• Rimostil May Increase Bone Density While Raising Good Cholesterol - Doctor's Guide, 9/27/99 - "The second effect was on HDL cholesterol levels. Falling HDL levels after menopause is one of the main reasons that older women suffer heart disease and stroke. P-081 caused an average 28% rise in HDL levels, essentially restoring their HDL levels to pre-menopausal levels" - see Rimostil at iHerb.
• Prolonged treatment with slow release nicotinic acid in patients with type II hyperlipidemia - Pol Arch Med Wewn. 1997 Nov;98(11):391-9
• Experts Urge Physicians and Patients To Look Beyond LDL Cholesterol - Doctor's Guide, 9/10/97
• Biological effects of hesperidin, a Citrus flavonoid. (note II): hypolipidemic activity on experimental hypercholesterolemia in rat - Farmaco. 1995 Sep;50(9):595-9 - "Hesperidin, the most important flavanone of Citrus sp., significantly increases HDL"
• A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients - JAMA. 1994 Mar 2;271(9):672-7 - "None of the patients taking IR niacin developed hepatotoxic effects, while 12 (52%) of the 23 patients taking SR niacin did"

Other Information:

• High HDL-C Levels Linked to Increased - Medscape, 1/20/23 - "In a fully adjusted model, each standard deviation increment in HDL-C level was associated with a 14% higher risk of fractures (HR, 1.14). When analyzed in quintiles, compared with participants in Q1, those in Q5 had a 33% higher risk for fracture"
• High HDL (High-Density Lipoprotein) Cholesterol Increases Cardiovascular Risk in Hypertensive Patients - Hypertension 2022 Aug 15 - "Emerging evidence suggests that elevated levels of HDL-C (high-density lipoprotein cholesterol) could be linked to an increased mortality risk. However, to the best of our knowledge, the relationship between HDL-C and specific cardiovascular events has never been investigated in patients with hypertension ... Our population was divided in 3 groups according to the HDL-C plasma levels: HDL-C<40 mg/dL (low HDL-C); HDL-C between 40 and 80 mg/dL (medium HDL-C); and HDL-C>80 mg/dL (high HDL-C). At the follow-up analysis, adjusting for potential confounders, we observed a total of 245 cardiovascular events with a significantly increased risk of cardiovascular events in the low HDL-C group and in the high HDL-C arm compared with the medium HDL-C group. The spline analysis revealed a nonlinear U-shaped association between HDL-C levels and cardiovascular outcomes. Interestingly, the increased cardiovascular risk associated with high HDL-C was not confirmed in female patients"
• Very High HDL-C: Too Much of a Good Thing? - Medscape, 5/26/22 - "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 ... A U-shaped association was found, with higher risk for all-cause and cardiovascular mortality in patients with both very low and very high, compared with midrange, HDL-C values"
• U-Shaped Relationship of High-Density Lipoprotein Cholesterol and Incidence of Total, Ischemic and Hemorrhagic Stroke: A Prospective Cohort Study - Stroke 2022 Jan 28 - "Both low and high cumulatively averaged HDL-C were associated with an increased risk of ischemic and hemorrhagic strokes"
• Association between high-density lipoprotein cholesterol and type 2 diabetes mellitus among Chinese: the Beijing longitudinal study of aging - Lipids Health Dis 2021 Jul 17 - "When research participants were separated into four groups on the basis for quartiles of their levels of HDL-C measured at baseline, and incidence of diabetes declined with higher baseline HDL-C levels at 12.60, 9.70, 5.38, and 5.22 per 1000 person-years, respectively"
• High-density Lipoprotein Cholesterol Is Negatively Correlated with Bone Mineral Density and Has Potential Predictive Value for Bone Loss - Lipids Health Dis 2021 Jul 25 - "Many studies have shown that lipids play important roles in bone metabolism ... This study demonstrated that HDL-C levels exhibit an inverse correlation with BMD. Especially in females, clinicians need to be alert to patients with high HDL-C levels, which may indicate an increased risk of osteoporosis or osteopenia. For these patients, close monitoring of BMD and early intervention may be necessary"
• 'Good cholesterol' may protect liver - Science Daily, 7/22/21 - "the researchers identified a special type of HDL called HDL3 that, when produced by the intestine, blocks gut bacterial signals that cause liver inflammation. If not blocked, these bacterial signals travel from the intestine to the liver, where they activate immune cells that trigger an inflammatory state, which leads to liver damage"
• Another way “good” cholesterol is good: combatting inflammation - AHA, 4/12/21 - "HDL anti-inflammatory capacity was significantly higher in people who remained healthy (31.6%) than in those who experienced a cardiovascular event (27%); ... The association of anti-inflammatory capacity with cardiovascular events was independent of the established biomarkers of HDL cholesterol and C-reactive protein levels, and was also independent of cholesterol efflux capacity; ... For every 22% increase in the ability of HDL particles to suppress inflammation in endothelial cells, participants were 23% less likely to have a cardiovascular event during the next decade; ... The amount of protection from increased HDL anti-inflammatory capacity was higher in women than in men; and ... Risk prediction was improved by adding HDL anti-inflammatory capacity to the Framingham Risk Score, or by replacing HDL cholesterol levels with this new measure of HDL function."
• HDL-C: Is It Time to Stop Calling It the 'Good' Cholesterol? - Medscape, 7/17/18 - "Recent data from two population-based cohorts in Copenhagen of over 100,000 people showed that all-cause mortality rates increased significantly for men with HDL-C levels above 97 mg/dL and for women above 135 mg/dL.[6] This mirrored findings from a Canadian big data cohort of more than 630,000 individuals that saw higher risk for noncardiovascular death at fasting levels above 70 mg/dL for men and 90 mg/dL for women.[7] The researchers hypothesized that extremely high levels may reflect dysfunctional HDL-C"
• Can Your ‘Good’ Cholesterol Be Too High? - NYT, 8/29/17 - "an HDL of 73 milligrams per deciliter in men and 93 in women was associated with the lowest all-cause mortality. Compared with that, men with HDL levels of 97 to 115 had a 36 percent increased risk for death, and twice the risk above 116. Women at greater than 135 had a 68 percent increased risk. (Only 2.3 percent of men had levels above 97, and 0.3 percent of women had levels above 135.) ... Low HDL, too, was tied to higher mortality risk, consistent with other studies. At levels under 39, the lower the HDL, the greater the increased risk for death"
• Gender-specific associations between lipids and cognitive decline in the elderly - Eur Neuropsychopharmacol. 2014 Feb 17 - "In men, a hypercholesterolemic pattern in late-life (high total cholesterol (T-C), low HDL-C, high LDL-C levels) was associated with a 25 to 50% increased risk of decline over 7 years in psychomotor speed, executive abilities, and verbal fluency ... In contrast, in women, a 30% higher rate of decline was found in psychomotor speed with high HDL-C levels and in executive abilities with low levels of LDL-C and triglycerides, in interaction with hormonal treatment. For men and women, vascular pathologies only slightly outweighed the risk related to lipids. This suggests a complex gender-specific pattern of cognitive decline involving genetic vulnerability in men and hormonal status in women" - Note:  Did I read that right?  HDL-C is good for cognition in men but bad for cognition in women?
• Cholesterol levels linked to early signs of Alzheimer's in brain - nbcnews.com, 12/30/13 - "Reed and his team studied brain scans of 74 patients in stroke clinics and senior centers using Pittsburgh Compound B, or PIB, a tracer dye that highlights amyloid in the brain. The patients were, for the most part, normal and free of any symptoms of dementia ... But when the scientists measured the cholesterol in their blood, and teased out the two types, they found that patients with high levels of low-density lipoprotein or LDL cholesterol and low levels of high-density lipoprotein or HDL cholesterol showed higher PIB levels ... That means that the good and bad effects of the two kinds of cholesterol may occur long before people develop Alzheimer’s symptoms, perhaps offering a new chance for early intervention ... The American Heart Association has long said that keeping levels of HDL “good” cholesterol up — above 60 milligrams per deciliter of blood — and levels of LDL “bad” cholesterol — below 100 mg/dL — can prevent heart disease. But this new study underscores the benefit for the brain" - See niacin at Amazon.com (to raise HDL.  See my niacin page).
• How 'good cholesterol' stops inflammation - Science Daily, 12/9/13 - "To put it simply, high HDL levels in blood are an important protective factor against sustained inflammation"
• 'Good' cholesterol controls blood glucose - Science Daily, 10/30/13 - "without ApoA-I, burning of calories is reduced in skeletal muscle resulting in increased blood glucose and weaker muscle function. The scientists then determined that HDL cholesterol and its protein ApoA-I both enhance usage of glucose and calories inside muscle cells. Raising HDL and ApoA-I levels in animal models resulted in protection against hyperglycemia and age-related symptoms such as decline of muscle performance or fat mass gain. Improved calorie burning in mitochondria (the "power plants" in each cell) was further indicated by a marked reduction of circulating Fibroblast Growth Factor 21, a novel biomarker for mitochondrial dysfunction ... Our results link for the first time low HDL-cholesterol with impaired use of glucose and burning of calories in type 2 diabetes" - [Abstract] - See my niacin page and niacin at Amazon.com.
• Low Levels of High Density Lipoprotein Cholesterol and Increased Risk of Cardiovascular Events in Stable Ischemic Heart Disease Patients: A Post Hoc Analysis from the COURAGE Trial - J Am Coll Cardiol. 2013 Aug 8 - "While low HDL-C level is a powerful and independent predictor of cardiovascular risk, recent data suggest that this may not apply when low-density lipoprotein cholesterol (LDL-C) is reduced to optimal levels using intensive statin therapy ... performed a post hoc analysis in 2,193 men and women with stable ischemic heart disease (SIHD) from the COURAGE trial ... In the overall population, the rate of death/MI was 33% lower in the highest HDL-C quartile as compared with the lowest quartile, with quartile of HDL-C being a significant, independent predictor of death/MI (P = 0.05), but with no interaction for LDL-C category (P=0.40). Among subjects with LDL-C levels < 70 mg/dL, those in the highest quintile of HDL-C had a 65% relative risk reduction in death or MI as compared to the lowest quintile, with HDL-C quintile demonstrating a significant, inverse predictive effect" - See niacin at Amazon.com and my niacin page.
• Role of HDL cholesterol and estimates of HDL particle composition in future development of type 2 diabetes in the general population: The PREVEND Study - J Clin Endocrinol Metab. 2013 May 20 - "High density lipoproteins (HDL) may directly stimulate β-cell function and glucose metabolism ... Higher HDL cholesterol, as well as higher HDL-cholesterol/apoA-I and HDL-cholesterol/apoA-II ratios are strongly and independently related to lower risk of future type 2 diabetes"
• Low HDL-C predicts risk and PCI outcomes in the Han Chinese population - Atherosclerosis. 2012 Oct 3 - "Low HDL-C was the most powerful lipid parameter for predicting the risk and the clinical outcome of CHD in the Han Chinese population"
• Serum high-density lipoprotein cholesterol and progression to arterial stiffness in middle-aged and elderly Chinese - Nutr Metab Cardiovasc Dis. 2012 Sep 22 - "participants in the highest quartile of HDL-c had an odds ratio of 0.442 (95% CI 0.268-0.729) for developing high arterial stiffness compared with participants in the lowest quartile" - See niacin at Amazon.com.
• Measuring HDL particles as opposed to HDL cholesterol is a a better indicator of coronary heart disease, study suggests - Science Daily, 7/11/12
• Not all 'good cholesterol' is 'good': Raising HDL not a sure route to countering heart disease - Science Daily, 5/16/12
• Raising HDL Levels May Not Lower Heart Attack Risk - WebMD, 5/16/12 - "Many clinicians still prescribe the vitamin niacin to help raise HDL levels, even though a government-funded trial proved disappointing ... The trial was halted early a year ago when it was determined that people with heart disease who had low HDL levels did not benefit from the treatment ... The drug company Pfizer abandoned its experimental HDL-boosting drug torcetrapib in 2006 when trials showed an increase in heart attack and stroke risk among users ... the new research casts even more doubt on the strategy of raising HDL to lower heart and stroke risk ... HDL levels are related to risk, but that doesn't mean that raising HDL is beneficial ... What we do know is that lowering LDL has a big impact on risk, so the take-home message remains, 'Get those LDL numbers down'"
• Erectile Dysfunction / Impotence - Prostate Health Guide - U. of Maryland Medicine - "Direct risk factors for erectile dysfunction may include the following: ... low levels of HDL (high-density lipoprotein)"
• LCAT, HDL Cholesterol and Ischemic Cardiovascular Disease: A Mendelian Randomization Study of HDL Cholesterol in 54,500 Individuals - J Clin Endocrinol Metab. 2011 Nov 16 - "Low plasma HDL cholesterol levels robustly associated with increased risk of MI but genetically decreased HDL cholesterol did not. This may suggest that low HDL cholesterol levels per se do not cause MI"
• HDL-cholesterol and prediction of coronary heart disease: Modified by physical fitness?: A 28-year follow-up of apparently healthy men - Atherosclerosis. 2011 Oct 17 - "High-density lipoprotein cholesterol (HDL) and physical fitness (PF) ... The highest HDL quartile was associated with lower risk of CHD (HR: 0.57, 95% confidence interval [CI]: 0.43-0.74), fatal CHD (HR: 0.56, CI: 0.36-0.86), fatal CVD (HR: 0.64, CI: 0.46-0.88) and all-cause death (HR: 0.80, CI: 0.65-0.99) compared to the lowest quartile. Adjustments for PF or changes in PF over 8.6 years did not change the results except for all-cause death, which was not significantly different between HDL quartiles. We found no interaction between HDL and PF"
• Change in high-density lipoprotein cholesterol and risk of subsequent hospitalization for coronary artery disease or stroke among patients with type 2 diabetes mellitus - Am J Cardiol. 2011 Oct 15;108(8):1124-8 - "During a mean follow-up of 55.8 +/- 23.8 months, 3,023 patients (10.1%) experienced a CVD hospitalization. After multivariate adjustment, each 5 mg/dl of baseline HDL cholesterol was significantly associated with a 6% lower CVD hospitalization risk (hazard ratio 0.94 per 5 mg/dl, 95% confidence interval 0.92 to 0.95, p <0.0001) and each 5-mg/dl increase in HDL cholesterol was associated with a 4% CVD risk reduction (hazard ratio 0.96, 95% confidence interval 0.94 to 0.99, p <0.003). In the categorical analysis, a ≥6.5-mg/dl HDL cholesterol decrease was associated with an 11% increased CVD risk (hazard ratio 1.11, 95% confidence interval 1.00 to 1.24, p = 0.047) and a ≥6.5-mg/dl increase was associated with an 8% CVD risk reduction (hazard ratio 0.92, 95% confidence interval 0.84 to 1.01, p = 0.077) relative to those with stable HDL cholesterol"
• Influence of low high-density lipoprotein cholesterol on arterial stiffening and left ventricular diastolic dysfunction in essential hypertension - J Clin Hypertens (Greenwich). 2011 Oct;13(10):710-5 - "In univariate regression analysis, HDL cholesterol was inversely associated with arterial stiffness parameter and E/Em (r=-0.23 and r=-0.27, respectively, P<.01). The association of HDL cholesterol with arterial stiffness and LV diastolic function was observed in both men and women. Triglycerides were weakly correlated with arterial stiffness parameter and E/Em, while low-density lipoprotein and total cholesterol were not. In multiple regression analysis, only low HDL cholesterol was found as an independent predictor for both arterial stiffness and LV diastolic dysfunction. Enhanced arterial stiffness is associated with LV diastolic dysfunction. Low HDL cholesterol may lead to the deterioration of both arterial stiffness and LV diastolic function in patients with essential hypertension"
• Serum total and HDL cholesterol and risk of prostate cancer - Cancer Causes Control. 2011 Sep 14 - "After excluding the first 10 years of follow-up, men with higher serum total cholesterol were at increased risk of overall (≥240 vs. <200 mg/dl: HR = 1.22, 95% CI 1.03-1.44, p-trend = 0.01) and advanced (≥240 vs. <200 mg/dl: HR = 1.85, 95% CI 1.13-3.03, p-trend = 0.05) prostate cancer. Higher HDL cholesterol was suggestively associated with a decreased risk of prostate cancer regardless of stage or grade ... In this population of smokers, high serum total cholesterol was associated with higher risk of advanced prostate cancer, and high HDL cholesterol suggestively reduced the risk of prostate cancer overall. These results support previous studies and, indirectly, support the hypothesis that statins may reduce the risk of advanced prostate cancer by lowering cholesterol"
• 'Good' cholesterol function as important as its levels - Science Daily, 6/23/11
• Niacin doesn't stop heart attacks, major study finds - Health - Heart health - msnbc.com - MSNBC, 5/26/11 - "The newest study tested Abbott Laboratories' Niaspan, an extended-release form of niacin that is a far higher dose than is found in dietary supplements ... the Niaspan users saw their HDL levels rise, and their levels of risky triglycerides drop, more than people who took a statin alone. But the combination treatment didn't reduce heart attacks, strokes or the need for artery-clearing procedures such as angioplasty ... That finding "is unexpected and a striking contrast to the results of previous trials," ... Also, there was a small increase in strokes in the high-dose niacin users — 28 among those 1,718 people given Niaspan compared with 12 among the 1,696 placebo users. The NIH said it was not clear if that small difference was merely a coincidence, as previous studies have shown no stroke risk from niacin. In fact, some of the strokes occurred after the Niaspan users quit taking that drug" - See my niacin and HDL pages for many more studies.  For one thing, there are waaaay more arguments for raising HDL than just heart disease.  Things such as centurions having unusually high HDL, prostate cancer, bowel cancer, impotence, Alzheimer's, etc., not to mention that it conflicts with other studies.
• Low levels of apolipoprotein A-I and HDL are associated with risk of prostate cancer in the Swedish AMORIS study - Cancer Causes Control. 2011 May 12 - "ApoA-I and HDL were inversely associated with PCa risk (e.g., HR for HDL: 0.93 (95% CI: 0.81-1.07), 0.88 (0.76-1.01), 0.81 (0.70-0.94), for second, third, and fourth quartiles compared with the first quartile; with p for trend: 0.004; HR for apoA-I: 1.00 (0.88-1.13), 0.93 (0.82-1.05), 0.88 (0.77-0.99),), for second, third, and fourth quartiles compared with the first quartile; with p for trend: 0.022). ApoB, LDL, and non-HDL were not associated with PCa risk"
• Evolving Concepts of the Role of High-Density Lipoprotein in Protection from Atherosclerosis - Curr Atheroscler Rep. 2011 Mar - "HDL is able to interact with and remove cholesterol from the lipid-laden foam cells in the peripheral vasculature with subsequent transportation to the liver for excretion. However, HDL has multiple other physiologic effects that may play a significant role in protection from atherosclerosis. HDL has been demonstrated to exhibit multiple beneficial effects on the coagulation system. Platelet function is improved by both direct and indirect mechanisms. HDL has a complex interaction with the protein C and protein S system. Thrombolytic balance is also improved by HDL. HDL has been demonstrated to have a significant natural antioxidant effect that inhibits the oxidative step required for low-density lipoprotein uptake by the macrophage. Additionally, HDL has also been demonstrated to exert multiple beneficial effects on endothelial function, including decreased apoptosis and endothelial repair" - See niacin at Amazon.com (niacin increases HDL).
• High levels of 'good' cholesterol may cut bowel cancer risk - Science Daily, 3/7/11 - "Each rise of 16.6 mg/dl in HDL and of 32 mg/dl in apoA reduced the risk of bowel cancer by 22% and 18%, respectively, after taking account of diet, lifestyle, and weight ... low HDL levels have been linked to higher levels of proteins involved in inflammation, while higher levels of proteins that dampen down the inflammatory response have also been linked to high HDL levels ... The pro inflammatory proteins boost cell growth and proliferation while curbing cell death, so HDL may alter the inflammatory process in some way"
• Relation Between High-Density Lipoprotein Cholesterol and Survival to Age 85 Years in Men (from the VA Normative Aging Study) - Am J Cardiol. 2011 Feb 4 - "We categorized initial HDL cholesterol into <40 mg/dl (reference group), 40 to 49 mg/dl, or ≥50 mg/dl ... Treating HDL cholesterol as a continuous predictor, we also determined the HR for each 10-mg/dl increment in HDL cholesterol. Fully adjusted HR (95% confidence interval) for survival to 85 years of age for participants with an initial HDL cholesterol level ≥50 mg/dl compared to the reference was 0.72 (0.53 to 0.98). Each 10-mg/dl increment in HDL cholesterol was associated with a 14% (HR 0.86, 0.78 to 0.96) decrease in risk of mortality before 85 years of age. In conclusion, after adjusting for other factors associated with longevity, higher HDL cholesterol levels were significantly associated with survival to 85 years of age" - See niacin at Amazon.com (niacin increases HDL).
• From dusty punch cards, new insights into link between cholesterol and heart disease - Science Daily, 1/5/11 - "He also found an old punch card machine to extract their data. Then, with the help of students and research assistants, he located and contacted 97 percent of the people in Gofman's study over the next nine years ... Their 29-year follow-up uncovered 363 cases of coronary heart disease. They found that both HDL2 and HDL3 lowered heart disease risk, and that a one-milligram per milliliter increase in HDL2 produced a significantly larger reduction in coronary heart disease risk than a one-milligram per milliliter increase in HDL3" - I doubt if many people besides me even remember what punch cards were.
• Higher HDL-C Levels May Curb Alzheimer's Disease Risk - Medscape, 12/16/10 - "There was a definite threshold effect, the researchers say, with a clear reduction in AD risk for people in the highest HDL-C level quartile (>56 mg/dL) ... these analyses were limited by the small number of cases of vascular dementia (n = 16) ... the current study linking higher HDL-C to a lower risk for incident dementia contrast with a prior study by the same researchers. This earlier study involved 1168 participants recruited from the same community in 1992 – 1994 and showed no association between HDL-C and AD ... Compared with the 1992 – 1994 cohort, the 1999 – 2001 cohort had a higher proportion of subjects receiving lipid-lowering treatment (23.4% vs 14.5%), higher mean HDL-C levels (48.3 vs 47.2 mg/dL), and fewer individuals who smoked (9.4% vs 10.6%) and had heart disease (18.8% vs 34.1%)"
• High levels of 'good' cholesterol may be associated with lower risk of Alzheimer's disease - Science Daily, 12/13/10 - "The researchers defined higher levels of HDL cholesterol as 55 milligrams per deciliter or more ... higher levels of HDL cholesterol were associated with a decreased risk of both probable and possible Alzheimer's disease"
• Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio is the best surrogate marker for insulin resistance in non-obese Japanese adults - Lipids Health Dis. 2010 Dec 7;9(1):138 - "In non-obese subjects, the best marker of insulin resistance was low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio of 0.74" - Note:  I'm not sure what I missed on that quote.  See http://www.americanheart.org/presenter.jhtml?identifier=183 .  Ideally your LDL should be below 100.  In the average man, HDL cholesterol levels range from 40 to 50 mg/dL.  So assuming an LDL of 100, for LDL/HDL to be equal to .74 your HDL would have to be 135 which is nearly impossible.  The full article is at http://www.lipidworld.com/content/pdf/1476-511x-9-138.pdf and says "The optimal cut-off point to identifying insulin resistance for these markers yielded the following values: TG/HDL-C ratio of ≥1.50 and LDL-C/HDL-C ratio of ≥2.14 in non-obese subjects, and ≥2.20, ≥2.25 in overweight subjects. In non-obese subjects, the positive likelihood ratio was greatest for LDL-C/HDL-C ratio".
• Effects of pioglitazone and metformin fixed-dose combination therapy on cardiovascular risk markers of inflammation and lipid profile compared with pioglitazone and metformin monotherapy in patients with type 2 diabetes - J Clin Hypertens (Greenwich). 2010 Dec;12(12):973-82 - "fixed-dose combination (FDC) of pioglitazone/metformin compared with the respective monotherapies ... FDC and pioglitazone increased high-density lipoprotein cholesterol by 14.20% and 9.88%, respectively, vs an increase of 6.09% with metformin (P<.05, metformin vs FDC). Triglycerides decreased with all three treatments -5.95%, -5.54% and -1.78%, respectively; P=not significant). FDC and pioglitazone significantly decreased small low-density lipoprotein and increased large low-density lipoprotein particle concentrations. Reductions in high-sensitivity C-reactive protein were greater in the FDC and pioglitazone groups. Increases in adiponectin were significant in the FDC and pioglitazone groups (P<.0001 vs metformin). Overall, adverse events were not higher with the FDC. Thus, treatment with the FDC resulted in improved levels of CV biomarkers, which were better than or equal to monotherapy"
• More 'good' cholesterol is not always good for your health - Science Daily, 5/25/10 - "Patients in the high-risk subgroup were characterized as having high levels of C-reactive protein (CRP), a well-known marker of inflammation, in addition to high HDL cholesterol. Study authors believe genetics and environmental factors, particularly inflammation, influence whether high levels of HDL cholesterol are protective or if they increase cardiovascular risk in individual patients. Given an inflammatory environment, an individual's unique set of genes helps determine whether HDL cholesterol transforms from a good actor to a bad actor in the heart disease process"
• Study: Too Much Sugar Increases Heart Risks - Time Magazine, 4/21/10 - "Compared with people consuming less than 5% of their daily calories in added sugar, those in the highest consumption group — who got 25% or more of their daily calories in added sugar — were twice as likely to have low levels of HDL cholesterol, the beneficial lipid that mops up artery-clogging LDL cholesterol. According to government health guidelines, HDL levels below 50 mg/dL for women and 40 mg/dL for men are considered low; 43% of the highest sugar consumers recorded low HDL, while only 22% of the lowest sugar consumers did ... People eating the most added sugar also recorded the highest triglyceride levels ... Low HDL and high triglyceride levels are two of the primary risk factors for heart disease"
• Quality of HDL Differs in Diabetics But Improves With Niacin Therapy - Medscape, 12/22/09 - "HDL cholesterol in individuals with diabetes has impaired endothelial protective functions compared with the HDL from healthy subjects, although treatment with extended-release niacin can improve these endothelial protective effects" - See niacin at Amazon.com.
• HDL Cholesterol Inversely Associated With Cancer Risk - Doctor's Guide, 11/16/09 - "The investigators found a significant inverse relationship between baseline HDL-C levels and the rate of incident cancer, reporting that every 10 mg/dL increase in HDL-C was associated with a 24% (95% CI: 1%-41%) relative reduction in the cancer rate ... They also found a significant inverse relationship between baseline LDL-C and the rate of incident cancer, with every 10-mg/dL reduction in LDL-C associated with a 14% (95% CI: 9%-18%) relative increase in the cancer rate ... There was a significant direct relationship between both age and BMI and rate of incident cancer, with every 5-year increase in age associated with a 28% (95% CI: 16%-42%) relative increase in cancer (P < .001) and every 1-kg/m2 increase in BMI associated with an 18% (95% CI: 6%-31%) relative increase in the cancer rate"
• In Taking the Garbage Out, the More HDL the Better, but the Truck Should Function - Medscape, 11/10/09 - Good 4 minute video on HDL cholesterol.  Discusses the 5 types of HDL and that high HDL can be deceiving because it's the type of HDL that counts.
• Low HDL-cholesterol is associated with the risk of stroke in elderly diabetic individuals: Changes in the risk for atherosclerotic diseases at various ages - Diabetes Care. 2009 Jun 9 - "IHD and CVD occurred in 1.59% and 1.43% of participants over 2-year period. The relation of lower HDL-cholesterol and/or higher LDL-cholesterol to occurrence of IHD in subjects<65 y.o. was significant. Lower HDL-cholesterol was also significantly related to CVD in subjects >=65y.o. and especially those>=75 y.o. (n=1016; odds ratio, 0.511*; 95%CI, 0.239- 0.918, *P<0.05). Stepwise multiple regression analysis with onset of CVD as a dependent variable showed same result. Conclusion: Lower HDL-cholesterol is an important risk factor for not only IHD but also CVD, especially in the diabetic elderly" - See niacin at Amazon.com (niacin increases HDL).
• Pioglitazone Improves Endothelial Function with Increased Adiponectin and High-density Lipoprotein Cholesterol Levels in Type 2 Diabetes - Endocr J. 2009 Jun 9 - "After treatment, HbA1c levels equally decreased in both groups, but PIO-treated group had significantly increased high-density lipoprotein cholesterol (HDL-C) levels, and decreased triglyceride, fasting insulin levels and HOMA-R. After treatment, increases in %FMD, plasma HDL-C and adiponectin (APN) levels were significantly greater in PIO-treated group than those in control group. Changes of %FMD showed significant positive correlations with those of plasma APN and HDL-C levels. In conclusion, the present study showed that treatment of T2DM improved endothelial function with greater increases in %FMD, APN and HDL-C levels in PIO-treated group than those in control group, suggesting the beneficial effect of PIO on endothelial function in T2DM" - See pioglitazone at OffshoreRx1.com.
• Leukocyte telomere length is associated with HDL cholesterol levels: The Bogalusa heart study - Atherosclerosis. 2009 Jan 24 - "Diminished levels of HDL-C are associated with an increased risk for atherosclerosis. Shortened leukocyte telomere length (LTL) also entails an increased atherosclerotic risk ... Multivariate regression analyses showed that LTL was positively associated with HDL-C in childhood (regression coefficient (bp per mg/dL) beta=3.1, p=0.024), adulthood (beta=4.4, p=0.058) and AUC from childhood to adulthood ... A slower rate of LTL shortening per year was associated with higher HDL-C AUC in the total sample (p=0.033), adjusting for baseline LTL ... As HDL-C exerts anti-oxidant and anti-inflammatory effects and LTL registers the accruing burden of oxidative stress and inflammation, the association between HDL-C and LTL might be explained by the lifelong status of oxidative stress and inflammation" - Note:  Telomere length is associated with longer lifespan.  Niacin increases HDL.  See niacin at Amazon.com.
• Sex Hormones Link To Heart Risk - Science Daily, 8/31/08 - "one of the sex hormones - estradiol - was associated positively with total cholesterol and negatively with HDL-cholesterol. Circulating concentrations of another sex hormone - estrone - showed strong positive associations with both total cholesterol and LDL-cholesterol ... Thus, men with the highest concentrations of estrone and estradiol may have the highest level of cardiovascular risk as their levels of detrimental LDL-cholesterol are high whilst their cardio-protective HDL-cholesterol is low" - See my aromatization page for ways to reduce these.
• Total Cholesterol Management: Taking Complete Control - PowerPak.com, exp. 7/31/10 - "In the Helsinki Heart Study, a randomized, double-blind, five-year primary prevention study, a 1% increase in HDL-C levels was shown to reduce the risk of CVD by 3% in patients (p<0.05).26 In a secondary prevention trial, an 11% reduction in CVD events was associated with every 5-mg/dL increase in HDL-C levels"
• HDL-C Tied to Lower Extremity Performance - Physician's Weekly, 8/18/08 - "Men with HDL-C levels that were greater than 55 mg/dL had, on average, a three times greater probability of having the highest performance indexes for lower extremities, including: ... 4-meter fast walking speed (odds ratio, 2.57) ... 400-meter walking speed (odds ratio, 3.74) Knee extension torque (odds ratio, 3.63)" - See niacin at Amazon.com (niacin increases HDL but that statement hasn't been approved by the FDA even thought I feel that having the government have to approve a statement is a violation of the First Amendment).
• Low Levels Of Good Cholesterol Linked To Memory Loss, Dementia Risk - Science Daily, 6/30/08 - "Researchers defined low HDL as less than 40 mg/dL ... At age 60, participants with low HDL had a 53 percent increased risk of memory loss compared to the high HDL group" - [WebMD] - The best way to increase HDL is niacin.  See niacin at Amazon.com.  Start slow maybe even with the 100 mg capsules.  It took me about three months to get immune to the flush from 2000 mg per day.  Taking it with soup seems to be the best.
• "Delipidated" HDL: A new, autologous option for plaque regression? - theheart.org, 5/16/08 - "the apheresis procedure did indeed increase the proportion of pre-beta HDL (from about 5.6% in the sample to 92.8% in the sample) and reduced the proportion of alpha HDL (from about 92.8% of the sample to 20.9% in the sample). Associated with the increase in pre-beta HDL was a fivefold rise in cholesterol efflux seen in patients receiving the delipidated plasma vs the control group, they report. All reinfusion sessions were well tolerated, and there was no signal of an adverse biochemical or hemodynamic reaction to therapy"
• Not Enough 'Good' Cholesterol Makes It Harder To Recover From Stroke - Science Daily, 11/26/07 - "People with low levels of HDL, high levels of homocysteine, and diabetes are twice as likely as those without such problems to have poorer cognitive function and greater disability after stroke"
• New Combination Drug Improves Multiple Cholesterol Disorders in Single Pill - Doctor's Guide, 11/5/07 - "Simcor combines prescription niacin and simvastatin, two FDA-approved medications with established safety profiles, to target good cholesterol (HDL), bad cholesterol (LDL), and triglycerides in a single pill" - Sounds stupid to me.  Why would you pay prescription drug prices for something that is dirt cheap like niacin.  It is the Niaspan form of niacin, which they claim has less flush.  I tried Niaspan and couldn't tell any difference in the flush plus the flush eventually stopped even with immediate release niacin.  Plus I worry about increased liver damage with Niaspan.  Click here for the study that concerns me which was sustained release niacin, not Niaspan but it would seem to be similar.  Plus immediate release niacin is about 20% more effective at raising HDL than Niaspan.  Click here and note where Niaspan is on the graph.  I'm just eye balling the 20%.
• Improving The Assessment Of Coronary Heart Disease Risk In Chinese - Science Daily, 10/12/07 - "the risk of developing coronary heart disease was more than three times as high in participants with the highest values of both apolipoprotein B and the ratio of the total cholesterol over HDL-C than patients who did not have the disease"
• Low HDL Cholesterol, Even When LDL Levels Are Low, Is Cardiovascular Dynamite, New TNT Analysis Shows - Medscape, 10/3/07 - "Among patients treated with statins, including those who achieved very low levels of cholesterol with high-dose statin therapy, high-density lipoprotein (HDL)-cholesterol levels are still predictive of major cardiovascular (CV) events ... In the determination of the five-year risk of major CV events across the different quintiles, univariate analysis showed the event rate to be reduced by 40% in the highest quintile when compared with subjects with the lowest HDL-cholesterol levels" - See niacin at Amazon.com.
• "Good" Cholesterol Earns Its Name - WebMD, 9/26/07 - "the patients with the highest HDL cholesterol levels were the least likely to have a heart attack, stroke, or cardiac arrest ... The higher the patients' HDL cholesterol level was, the lower their odds of having a heart event during the study. That includes patients who got their LDL "bad" cholesterol below 70 mg/dL"
• Framingham Study: The apoB/apoA-1 ratio does not provide clinical utility over total/HDL cholesterol - theHeart.org, 8/14/07 - "In men, non-HDL cholesterol, apoB, the total/HDL-cholesterol ratio, the LDL/HDL-cholesterol ratio, and the apoB/apoA-1 ratio were all positively associated with CHD risk of approximately the same magnitude and statistical significance. ApoA-1 and HDL cholesterol were associated with reduced CHD risk. Similar results were observed for women, but apoA-1 was not significantly associated with incident CHD. In men and women, LDL and total cholesterol were not significantly associated with CHD risk"
• Heavy Drinking Raises Blood Pressure In Older Men Regardless Of 'Good' Cholesterol - WebMD, 8/31/07 - "When looking at men of all ages, those with the lowest level of good cholesterol had the highest blood pressure in all three groups: nondrinkers, moderate drinkers and heavy drinkers. However, high levels of good cholesterol HDL did not do as much for the heavy drinkers"
• High Hostility Linked with Poor Ability to Cope With Stress, Low HDL Levels - Medscape, 8/30/07 - "individuals who were very hostile were more likely to perceive problems as stressful and to cope with stress by using interpersonal hostility, self-blame, and social isolation; they also tended to have lower levels of HDL"
• HDL Levels and Particle Size: Does Size Matter at Both Ends of the Scale? - Medscape, 8/7/07 - "very large HDL particles would be associated with an increased risk for coronary artery disease ... These data suggest that very large HDL particles no longer seem to confer protection against cardiovascular disease, at least when levels of apoA-1 and apoB are kept constant, but this lack of protection does not seem to hold true for apoA-1"
• Sex differences in the relation of HDL cholesterol to progression of carotid intima-media thickness: The Los Angeles Atherosclerosis Study - Atherosclerosis. 2007 May 3 - "carotid intima-media thickness (IMT) (an indicator of subclinical atherosclerosis) in middle age ... IMT at baseline was inversely associated with serum levels of HDL-C and the associations were comparable in women and men ... Our results suggest that although HDL-C was protective against progression of carotid atherosclerosis in middle-aged men, anti-atherogenic effects of HDL may diminish in women around the age of menopause"
• Improving Outcomes With HDL Cholesterol - Physician's Weekly, 4/9/07 - "Patients who have high HDL levels appear to have better protection against vascular disease than others and some variants of HDL may actually reduce plaque in the coronary arteries. Essentially, HDL acts as a scavenger compound; it moves the lipids from the blood vessel to the liver, where they are then excreted from the body ... Currently, in the United States, the only medication other than statins designed specifically to help physicians raise the HDL cholesterol levels in their patients is niacin" - See niacin at Amazon.com.
• What Makes Good Cholesterol So 'Good' For Us? - Science Daily, 3/2/07 - "High levels of good cholesterol (high density lipoprotein (HDL)) are associated with protection from cardiovascular disease, which remains the leading cause of death in the United States"
• Study: HDL, or 'good' cholesterol looks better - USA Today, 2/6/07 - "patients' clogged arteries began to clear when statins drove their LDL levels down to 87.5 milligrams per deciliter of blood and their HDL up by 7.5%"
• HDL Effects of Statins Important - Medscape, 2/6/07 - "Statins increase HDL-C by around 5% to 15% ... Substantial atheroma regression (>5%) was observed in patients with levels of LDL-C less than the mean (87.5 mg/dL) and increases of HDL-C greater than the mean (7.5%; p<0.001) during treatment ... This, to our knowledge, is the first time that increases in HDL-C levels have been shown to be an independent predictor of a beneficial outcome with statin therapy"
• Gene Tied To Longevity Also Preserves Ability To Think Clearly - Science Daily, 12/26/06 - "Centenarians were three times likelier to possess CETP VV compared with a control group representative of the general population and also had significantly larger HDL and LDL lipoproteins than people in the control group ... Researchers believe that larger cholesterol particles are less likely to lodge themselves in blood vessels" - Could niacin do the same thing?  See:
  • Effects of extended-release niacin on lipoprotein particle size, distribution, and inflammatory markers in patients with coronary artery disease - Am J Cardiol. 2006 Sep 15;98(6):743-5 - "Addition of niacin resulted in a 32% increase in large-particle HDL (p <0.001), an 8% decrease in small-particle HDL (p = 0.0032), an 82% increase in large-particle LDL (p = 0.09), and a 12% decrease in small-particle LDL (p = 0.008)"
• Here's How to Get More 'Good' Cholesterol - ABC News, 7/28/06 - "raising HDL is likely as important as lowering LDL when it comes to reducing the risk of heart attack"
• High Good Cholesterol Trumps Low Bad Cholesterol For Heart Protection - Science Daily, 4/3/06 - "Having a high level of HDL cholesterol -- the good cholesterol -- is more important than having a low level of LDL -- the bad cholesterol -- in protecting individuals from heart attack ... This study was repeated with stroke as the outcome rather than heart disease, and the same results were the same"
• Lower HDL Cholesterol Increases Risk of Cardiovascular Event - Medscape, 3/14/06 - "Our study, in which half the population achieved LDL levels below 80 mg/dL, clearly shows that even if LDL is low, HDL is still important ... every 1 mg/dL increase in HDL cholesterol concentration was associated with an approximate 2% reduction in the relative risk of a major cardiovascular event ... There's diet, exercise, and, if the patient can tolerate it, niacin"
• HDL Levels and LDL-C/HDL-C Ratio Potential Targets for Future Drug Therapy - Doctor's Guide, 3/13/06 - "major cardiovascular event (MCVE) ... a 1 mg/dL increase in HDL-C concentration translated to an approximate reduction of about 2% in the relative risk of an MCVE"
• Raising HDL-Cholesterol and Reducing Cardiovascular Risk: An Expert Interview With H. Bryan Brewer, Jr, MD - Medscape, 12/27/05
• Adding Niacin to Lovastatin Therapy Might Improve Efficacy for Dyslipidemia - Doctor's Guide, 10/5/05 - "Niacin has been shown to be one of the most effective drugs for improving levels of high-density lipoprotein (HDL) cholesterol, or good cholesterol ... Combining the best LDL lowering and best HDL raising drugs makes sense"
• HDL-C and the diabetic patient: Target for therapeutic intervention? - Diabetes Res Clin Pract. 2005 Jun;68 Suppl 2:S36-42. Epub 2005 Apr 7 - "Rosuvastatin has been shown to be at least as effective at increasing HDL-C compared with atorvastatin, pravastatin or simvastatin"
• How HDL Keeps The Heart Healthy - Science Daily, 5/29/05
• Doctors Seek Way to Boost Some Cholesterol - Intelihealth, 3/8/05 - "HDL works like arterial Drano, clearing away cholesterol and carrying it to the liver for disposal. The more of it, the better: each point of increase in HDL has been found to reduce the risk of heart disease by 2 percent to 3 percent"
• Laboratory Investigations of Erectile Dysfunction - WebMD - "men with erectile dysfunction frequently have low levels of high-density lipoproteins, the good form of cholesterol."
• Low levels of HDL cholesterol linked to breast cancer risk - US News, 12/1/04 - "Women with high HDL levels were 25 percent less likely to get postmenopausal breast cancer than women with low HDL cholesterol. The difference was even bigger for women who were overweight"
• Two-Pronged Cholesterol Approach Works - HealthDay, 11/11/04 - "Niacin is the most effective treatment to treat low HDL ... Overall, combining niacin with a statin slowed disease progression 68 percent more than a statin alone. The combination treatment also resulted in a 60 percent reduction in heart attacks, deaths, strokes, and other coronary events"
• Effectiveness of simvastatin therapy in raising HDL-C in patients with type 2 diabetes and low HDL-C - Curr Med Res Opin. 2004 Jul;20(7):1087-94 - "Both simvastatin 80 and 40 mg significantly increased total HDL-C from baseline (mean increases of 8%"
• Benefit of 'Good' Cholesterol in Arteries Limited by Enzyme Linked to Heart Attack Risk - Doctor's Guide, 8/17/04 - "HDL becomes dysfunctional, Dr. Hazen said, when myeloperoxidase (MPO), an enzyme present in white blood cells, inhibits the HDL's ability to keep LDL, or "bad" cholesterol, from building up in artery walls"
• Overweight? Good Cholesterol May Fight Cancer - WebMD, 8/3/04 - "overweight, postmenopausal women with high levels of good HDL cholesterol have 67% less breast cancer than similar women with low HDL levels"
• Non-HDL Cholesterol and Apolipoprotein B Predict Cardiovascular Disease Events Among Men With Type 2 Diabetes - Diabetes Care. 2004 Aug;27(8):1991-7 - "Non-HDL cholesterol and apoB are more potent predictors of CVD incidence among diabetic men than LDL cholesterol. Statistically, the ratio of total to HDL cholesterol is the best predictor of CVD in this cohort of diabetic men"
• Specific Plasma Lipids Appear Associated with Vascular Dementia but Not With Alzheimer Disease - Doctor's Guide, 5/19/04 - "Lower levels of high-density lipoprotein cholesterol (HDL-C) and higher levels of non-HDL-C and low-density lipoprotein cholesterol (LDL-C) are associated with an increased risk of vascular dementia"
• Cholesteryl Ester Transfer Protein Raises Serum High-Density Lipoprotein Cholesterol Levels as Monotherapy and Combined with a Statin - Doctor's Guide, 4/12/04
• Drug Raises 'Good' HDL Cholesterol Levels - WebMD, 4/7/04 - "researchers examined the effects of a CETP inhibitor (torcetrapib) in 19 people with low HDL levels (below 40 mg per deciliter). Nine of the participants were also treated with a statin ... After four weeks of treatment with the drug, researchers found HDL cholesterol levels increased by 61% among those treated with the CETP inhibitor and statin and by 46% among those treated with the CETP inhibitor alone"
• Potential Heart Disease Breakthrough - WebMD, 11/4/03 - "It's called ApoA-I Milano ... a genetically engineered version of this "good" HDL cholesterol protein has been tested in a small human trial ... The findings exceed even the most optimistic expectations ... In five weeks, patients treated with ApoAI Milano had about a 4% decrease in plaque volume. That's 10 times greater reduction than ever seen before"
• Carbohydrate-Rich Diet Associated with Lower High-Density Lipoprotein Levels - Doctor's Guide, 10/6/03 - "The researchers defined glycaemic index as the measure of blood glucose after consumption of carbohydrate-containing foods, ranging in values from 1 to 100. Glycaemic load was defined as the carbohydrate content of a food multiplied by the glycaemic index and servings per week ... Results showed an inverse relationship between high-density lipoprotein (HDL) cholesterol level and both the glycaemic index and glycaemic load"
• Rosuvastatin Improves Plasma Lipid Ratios - Doctor's Guide, 10/1/03 - "Rosuvastatin significantly more effective than atorvastatin, simvastatin, and pravastatin in improving the ratios of total cholesterol to high-density lipoprotein cholesterol" - See Crestor (rosuvastatin) at drugstore.com.
• Doctors Ignore Diabetes Guidelines - WebMD, 8/18/03 - "Do you have diabetes? There's a one-in-three chance that if you do, you don't know ... Testing should be considered at a younger age -- and done more frequently -- in certain people: ... Anyone with high blood pressure (140/90 or higher) ... Anyone with an HDL "good" cholesterol of 35 or under and/or triglyceride levels of 250 or more ... Anyone with a fasting blood sugar level of 100 to 125"
• Low High-Density Lipoprotein Cholesterol a Risk Factor for Stroke in Elderly Patients - Doctor's Guide, 7/22/03
• Cholesterol Ratio More Indicative Than LDL - Physician's Weekly, 7/21/03 - "the ratio of LDL and HDL cholesterol may be better for identifying the risk of heart disease compared to relying solely on the individual levels of each kind of cholesterol. The study found that the ratio of LDL to HDL cholesterol and the ratio of total cholesterol to HDL cholesterol can better predict the risk of heart disease rather than measuring LDL levels alone. LDL/HDL ratios may more effective at identifying high-risk individuals and tracking their progress on cholesterol-lowering drugs. The researchers noted that despite newer recommendations incorporating HDL into risk assessment, LDL continues to be the major target of cholesterol-lowering therapy ... Certain low-fat diets that reduce both LDL and HDL levels may be less beneficial than diets that boost HDL cholesterol levels. Losing weight, quitting smoking, and exercising more often can increase HDL cholesterol"
• Lower cholesterol for healthy kidneys - USA Today, 7/20/03 - "men who had low levels of HDL or "good cholesterol" and elevated "bad" or LDL cholesterol were twice as likely to have evidence of kidney malfunction"
• High-Density vs Low-Density Lipoprotein Cholesterol as the Risk Factor for Coronary Artery Disease and Stroke in Old Age - Arch Intern Med. 2003;163:1549-1554 - "low HDL cholesterol level was associated with a 2.0-fold higher risk of fatal cardiovascular disease ... The mortality risk of coronary artery disease was 2.0 ... and for stroke it was 2.6"
• Estrogens as Antioxidants – Reducing Heart Disease in Younger Postmenopausal Women - Doctor's Guide, 7/4/03 - "If LDL becomes oxidised its ability to cause heart disease increases. If HDL becomes oxidised its ability to protect against heart disease is lessened ... estrogens can act as antioxidants, which neutralise free radicals, and hence protect HDL from oxidation. In addition, high levels of HDL are able to protect LDL from oxidation, and this ability is strongly enhanced when estrogens are present ... Although recent randomised control trials have shown that HRT in older women may not reduce the incidence of coronary heart disease, Dr. Bhavnani believes that this is not the whole story"
• A Healthy Heart - Newsweek, 6/16/03 - "If small LDL is the kind of cholesterol you definitely don’t want to have, then HDL2B is the kind you definitely do want to have, and the more the better. HDL2B is a superefficient type of HDL, the good cholesterol that helps clear partially blocked arteries. HDL2B, the strongest possible protection against heart disease, is measured as a percentage of total HDL, and Superko likes his patients to be above 35 percent (for postmenopausal women, above 45 percent)" - See below.  Many are recommending HDL be a lot higher than that. - Ben
• Hormone Replacement Normalises Cholesterol in African-American Women - Doctor's Guide, 5/18/03 - "randomised to daily combination HRT consisting of 0.625 of conjugated oestrogen and 2.5 mg of medroxyprogesterone ... Overall, the women had an 8% increase in total HDL cholesterol ... They found an 8% reduction in the ratio of LDL to HDL ... LDL composition measurements were not changed"
• Rosiglitazone Improves Cholesterol Profile in Patients with Type 2 diabetes - Doctor's Guide, 4/4/03 - "Rosiglitazone increases high-density lipoprotein cholesterol (HDLC) levels and improves the ratio of HDLC to total cholesterol in patients with type 2 diabetes ... mean HDLC levels increased 15%, from 45.3 to 51.9 mg/dL"
• Raising HDL-C Levels Slows CAD Progression and Reduces Mortality - Medscape, 4/3/04 - "Results of two studies of high-density lipoprotein cholesterol (HDL-C)-targeted therapies indicate that attacking heart disease by increasing HDL-C levels appears to slow progression of atherosclerosis and reduce mortality ... Although the protective effect of HDL-C is well known, "most researchers ignore this fact," said Henrietta Reicher-Reiss, MD, from Sheba Medical Center in Tel Hashomer, Israel. It is a costly oversight since "about half of heart attack victims have normal [low-density liprotein cholesterol (LDL-C) levels]," ... drugs designed to target HDL-C have a number of adverse effects. Niacin, for example, causes flushing, and fibrates are associated with gastrointestinal side effects. That side-effect profile might be a factor against this approach. Statins, on the other hand, tend to be very well tolerated"
• Exercise Training, Without Weight Loss, Increases Insulin Sensitivity and Postheparin Plasma Lipase Activity in Previously Sedentary Adults - Medscape, 3/19/03 - "Exercise, without weight loss, increases SI [insulin sensitivity] and PHPL activity in previously sedentary adults, without changing K2 or fasting lipid levels. Furthermore, increased LPL is associated with a decreased total:HDL ratio, and an increased LPL:HL ratio is associated with a decreased waist circumference. Therefore, even modest amounts of exercise in the absence of weight loss positively affect markers of glucose and fat metabolism in previously sedentary, middle-aged adults" - I threw this out because I didn't know that "decreased total:HDL ratio ... is associated with a decreased waist circumference" - This might be a long shot but that sounds like increasing insulin sensitivity via such methods as metformin and increasing HDL via supplements such as niacin might decrease pot bellies. - Ben
• HDL Cholesterol Level Linked To Longevity, Cognitive Function - Clinical Psychiatry News, 2/03 - "A group of centenarians maintained significantly higher than normal HDL cholesterol levels, and within the group the parameter was strongly correlated with cognitive function ... The centenarians' offspring were also significantly healthier than their spouses: They were half as likely to have diabetes or heart attacks and had significantly lower blood pressure. No strokes occurred among the offspring ... The presence of HDL might explain the health and longevity in these families. The serum concentration of HDL typically declines with age by a mean of 5 mg/dL every 8 years ... Had the decline followed the normal pattern, the centenarians' HDL would have been about 20 mg/dL. But the actual mean value in the group was 55 mg/dL"
• Unhealthy Trans Fats Not Labeled on Foods - WebMD, 2/10/03 - "[Trans fats] are there and they are not labeled ... Saturated fats are the only fats given special treatment on a product's label. Yet trans fats are just as bad. They may even be worse ... Trans fat increases 'bad' LDL cholesterol -- in some studies more than saturated fat ... It also has a tendency to reduce 'good' HDL cholesterol, which saturated fat doesn't do ... Trans fat also increases blood levels of two other bad actors. One is the kind of fat called triglycerides. The other is a particle called lipoprotein(a), which promotes clogged arteries ... Any amount of trans fat is bad"
• Exchange, Not Reduction, of Fats Improve Cholesterol Levels - Doctor's Guide, 1/15/03 - [Abstract]
• Statin-Niacin Combination Counters Dyslipidaemic Cardiovascular Risk - Doctor's Guide, 12/20/02 - "Combined statin-niacin is a safe, tolerated therapy that lowers low density lipoprotein cholesterol and raises high density lipoprotein cholesterol ... At niacin doses of at least 1000 (mean 1480) mg/day added to a constant statin regimen in 29 patients, high density lipoprotein cholesterol rose significantly (by 20 percent)"
• Big gut, other factors can kill you - USA Today, 12/3/02 - "People with this syndrome have at least three of the following risk factors: high blood sugar; a waist circumference of greater than 40 inches for men or 35 inches for women; lower-than-average HDL cholesterol (the so-called good cholesterol); high triglycerides and high blood pressure ... men who had the syndrome at the study's start had a two to three times greater chance of dying of a heart attack or a stroke during the study than men who did not have this collection of risk factors ... People getting a checkup should ask their family doctor to look for metabolic syndrome"
• Atkins diet good for cholesterol - USA Today, 11/18/02 - "After six months, the people on the Atkins diet had lost an average of 31 pounds, compared with 20 pounds on the AHA diet, and more people stuck with the Atkins regimen ... Total cholesterol fell slightly in both groups. However, those on the Atkins diet had an 11% increase in HDL, the good cholesterol, and a 49% drop in triglycerides. On the AHA diet, HDL was unchanged, and triglycerides dropped 22%. High triglycerides may raise the risk of heart disease" - That may be true but what about a diet devoid of anti-oxidants making you old before your time.  Plus, how much of that extra 11 pounds was water loss? - Ben
• Among Treated Hypertensive Patients, Low HDL Predicts Ventricular Remodeling - Doctor's Guide, 9/26/02 - "While low HDL cholesterol levels are well known to be a major risk factor for coronary heart disease, it is unclear whether it plays a role in hypertensive heart disease ... The findings suggest that low HDL-C may play an adverse role not only in coronary heart disease but also in hypertensive heart disease"
• Paediatric Non-High-Density Lipoprotein Cholesterol Data Available - Doctor's Guide, 9/9/02 - "They define non-HDL cholesterol as total cholesterol minus HDL cholesterol ... non-HDL cholesterol is a better screening tool than low-density lipoprotein (LDL) cholesterol for assessing CAD risk in adults because it includes all classes of atherogenic lipoproteins"
• Arterial Walls Thicker In Patients With Low Levels of High-Density Lipoprotein Cholesterol - Doctor's Guide, 2/20/02 - "A low plasma concentration of high-density lipoprotein (HDL) cholesterol is associated with significant pre-intrusive atherosclerosis. However, an above average level of HDL cholesterol does not lead to a further reduction of arterial wall thickening"
• Unexplained Link Between High Density Lipoproteins And Bone Density In Postmenopausal Women - Doctor's Guide, 12/20/01
• Ratio of Total to LDL Cholesterol Is Best Predictor Of Coronary Heart Disease - Doctor's Guide, 11/2/01 - "The total cholesterol/ HDL-C ratio was the most powerful lipoprotein predictor of future coronary heart disease ... Using a total cholesterol/HDL-C cholesterol ratio of 5.0 as the cut-off point was associated with significantly better specificity and accuracy and similar (though lower) sensitivity than an LDL-C level of 130 mg/dl (3.4 mmol/l)"
• More Good News About the 'Good' Cholesterol, High Levels of HDL Cholesterol Protect Against Stroke, Too - WebMD, 6/6/01 - "High levels of that "good" HDL cholesterol have been known to protect against heart disease. Now a new study shows that high HDL levels also protect people from suffering a stroke"