Question: I'm a 74-year-old man, and my HDL is consistently in the 35 range. I lift weights and do high intensity aerobics three to four times a week, and I don't smoke. I even take niacin twice a day in addition to other supplements. Nothing seems to help. Is it inherited?
Dr. Hibberd's Answer:
HDL is our good cholesterol, and its level is largely determined by our genetics. We want this level to be as high as possible, since this is the component of our lipids that "mops up" the dangerous low density lipoproteins (the LDL or bad cholesterol) that would otherwise form plaques inside of arterial walls. These plaques have a high risk of rupture and occlusion and cause a large majority of heart attacks and strokes.
Remember this is only a risk factor, not a death sentence, and it is quite possible to manipulate the HDL using prescription meds that your regular doctor or cardiologist should be familiar with. Self-medicating with niacin may help some, but the doses needed usually require medical supervision.
I advise you to consult your cardiologist or primary care physician to set up a treatment plan with goals to increase your HDL to at least 45 ... that is an increase of almost 30 percent that will decrease your vascular event risk by almost 60 percent!
Exercise and sensible diet aside, you deserve professional attention to improve your HDL levels as a very positive preventive maneuver on your part. Your heart and brain will be better-protected from insult and vascular damage if your HDL can be improved by as little as 10 points.