There’s a reason HDL cholesterol is called “good” cholesterol: Raising the body’s levels of HDL could lower your risk of heart attack and stroke, many scientists and doctors believe. That idea is supported by years of observational studies and small clinical trials, which show that low levels of HDL cholesterol can lead to a higher risk of heart events.
But experts were surprised last week when a trial that combined LDL-lowering statins with an HDL-raising niacin (vitamin B3) failed to produce the expected health benefits.
The study involved nearly 3,500 people who had a history of cardiovascular disease. While all subjects were given statins, half also took niacin.
People who took the combo therapy did see their HDL levels increase, but they were also more than twice as likely to suffer a stroke during the 32-month study period than those patients who took a statin only, according to an NIH release. However, the risk of stroke was low: 1.6 percent of subjects taking both drugs suffered a stroke, compared to .7 percent of those taking only a statin. The results may have been by chance, researchers admit.
As for heart attacks, there weren’t any during the study for either group.
So what’s going on? The LDL-lowering medication may have worked so well that it masked any benefits of increasing “good” HDL levels, said the University of Buffalo’s William Boden, M.D., who was one of the NIH study’s principal investigators.
Sure, but that doesn’t explain why the combination group had more strokes. “Lipid disorders are inherently complex,” Boden says. “And I think we need more research to find newer approaches to manage risk.”
“I still firmly believe that low HDL is a powerful risk factor,” he added.
Here’s one approach to lowering cholesterol—and improving heart health—that’s been proven over and over again: Diet and exercise. In fact, many men can even get off heart meds just by changing their lifestyle—here’s your plan. (Don’t stop taking them without your doctor's OK.)
“Even if you do use medicine, its effectiveness can be limited if you don’t include proper diet and exercise with your medication,” says Jeffrey Probstfield, M.D., a University of Washington professor and Boden’s co-investigator.
Here is some age-specific diet and exercise advice to ensure your ticker stays in tiptop shape throughout your 20s, 30s, 40s, and beyond. Don’t have heart issues yet? Keep it that way with these 10 Ways to Never Get Heart Disease.
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