In the latest twist on the nutritional conundrum of cholesterol, researchers have found that increased levels of the high density lipoproteins (HDLs), or good cholesterol, is not necessarily a good thing. In other words, it actually places certain people at a higher risk for the very health problems that it is supposed to protect them from. This includes coronary conditions like chest pains, heart attacks, and even death.

This comes in the aftermath of a study examining a drug, torcetrapib, that was designed to increase levels of HDLs in patients. The study, which was published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, resulted in a surprisingly high number of cardiac problems and death associated with elevating HDL levels in patients.

Needless to say, the findings do not clarify the relationship between cholesterol and good health. Nutritional science as a whole is continually in flux, and it seems that the flow of information is not only constant, and sometimes overwhelming, but can also be contradictory and confusing. For years we were told that cholesterol was bad and we went to great lengths to avoid it all costs, even in lieu of the fact that it is important for our very survival. Then, scientists began to realize that not all forms of cholesterol were bad for us, and distinguished between good cholesterol (HDLs) and bad cholesterol, also known as low density lipoproteins, or LDLs.

Consequently, there has been an intense focus on increasing levels of HDLs and lowering levels of LDLs, leading to a number of approaches all geared towards increasing the ratio of HDLs to LDLs, including diets, lifestyle choices, and medication. Unfortunately, the protective effect that researchers predicted has not always been the end result.

In the study in question, it was not exactly clear why certain patients suffered from elevated HDL levels, but the researchers did note a relationship to inflammation. In fact, the patients who were at high risk for heart disease due to increased levels of HDL also had high levels of a key inflammation marker, C-reactive protein (CRP). The authors believe that CRP in conjunction with genetic factors, including ones that modify cholesterol and mediate inflammation, contribute to the negative effects of increasing HDLs.

Though the outcome in these individuals was not as predicted, there is value in knowing which people will respond to treatment and which ones are placed at higher health risks. The ability to identify the high risk patients through genetic screening will enable doctors to target populations who will benefit most from therapies aimed at modifying cholesterol levels in their blood.

Despite the disappointing results, pharmaceutical companies continue to look at HDLs as an important part of maintaining good cardiovascular health through drug intervention.

If you have questions or concerns, voice them to your physician. For more information about good and bad cholesterol, visit the website for the American Heart Association.