Is an increase in my HDL level always good?

Spencer D. Kroll, MD
Internal Medicine
Studies in the past 18 months demonstrate that although there is an association between low HDL levels and cardiovascular disease, there is not convincing evidence to raise the HDL level by medication.  "Natural ways" to raise the HDL level are to increase exercise, eat a lower saturated-fat diet, lose weight, stop smoking, and drink small amounts of alcohol.  But raising HDL by medication has so far not panned out to lower cardiovascular risk.  It may be that the medications that were studied caused a rise in HDL that was dysfunctional.  This would mean that a rise in the absolute number of HDL achieved with medication may fool you into thinking you have achieved a level of protection.  Alternatively, there has been a lot of criticism of the design and the patient selection of these recent studies and it may be that more studies are needed.  For now, what we do know is that low HDL levels definitely correlate with cardiovascular risk and when the HDL is low, it becomes imperative for your doctor to address the other parts of the lipid profile which may be abnormal. 

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