Heart risk may be more closely tied to the molecules that
transport HDL than to the cholesterol itself, researchers found.
In a cohort study, patients with higher concentrations of HDL
particles had less atherosclerosis and fewer coronary heart
disease events than those with lower levels of the molecules,
even after adjusting for potential confounders, Rachel Mackey,
PhD, MPH, of the University of Pittsburgh, and colleagues
reported online in the Journal of the American College of
Cardiology. The lower risk seen with HDL cholesterol itself,
however, didn't hold up in adjusted models, they reported. "HDL
particles may be an alternative to HDL cholesterol as a marker
of HDL-related cardiovascular risk, if these findings are
confirmed in other studies and found to be cost-effective," they
wrote. HDL particles carry HDL cholesterol, and some recent work
has suggested that quantifying this "good" cholesterol alone may
not fully capture a patient's HDL-related risk. For instance,
promising drugs that raise HDL chol