HDL is called "good" cholesterol because cholesterol in this form travels away from the arteries and back to the liver for eventual elimination from the body. The higher your HDL, the lower your risk of heart disease. Indeed, studies on cholesterol and heart disease have suggested that each increase of 4 milligrams per deciliter of blood (mg/dl) in HDL results in a 10 percent decrease in the risk of adverse coronary events. In contrast, LDL ("bad") cholesterol combines with other substances that can build up in the walls of arteries to form "plaque." Over time, this plaque damages arterial walls, causing them to narrow and harden. Also, the rough surface of plaque can provide a site for blood to clot, sometimes completely blocking an artery, or forming an embolus that can travel elsewhere in the body and cause a stroke.
I discussed your question about raising your HDL without taking drugs with Steven Devries, M.D., preventive cardiologist and associate professor of medicine at Northwestern Memorial Hospital in Chicago. Dr. Devries said that Trilipix is a prescription drug that is most effective at lowering triglycerides (the chemical form in which fat moves through the bloodstream) but that it is also used for increasing HDL.
However, he said that there are some very effective ways to raise HDL without taking prescription drugs. The most potent agent for raising HDL is the B vitamin niacin. When used for this purpose, niacin has to be taken at doses much higher than found in daily multivitamins. Because of this, it should be used only under a doctor’s supervision. You will need to have liver function tests done before the start of therapy and periodically thereafter. You also should monitor your cholesterol monthly and keep your niacin dose to the lowest possible level to maintain improvement. If you decide to go this route, Dr. Devries advised avoiding "no-flush" or "flush-free" versions of niacin, which are not effective.
He also suggested the following lifestyle measures that can help you raise your HDL:
- Emphasize low glycemic load carbohydrates in your diet.
- Lose weight if you’re too heavy.
- Get regular aerobic exercise. (I recommend starting any new exercise program slowly and aiming for 30-45 minutes daily.)
Dr. Devries noted that even small increases in HDL can have big heart-health payoffs.
Andrew Weil, M.D.