Why is HDL the good cholesterol?

HDL is the good cholesterol because it protects the arteries from the
atherosclerosis process. HDL cholesterol extracts cholesterol particles from
the artery walls and transports them to the liver to be disposed through the
bile. It also interferes with the accumulation of LDL cholesterol particles in the
artery walls.
The risk of atherosclerosis and heart attacks is strongly related to HDL
cholesterol levels. Low levels of HDL cholesterol are linked to a higher risk,
whereas high HDL cholesterol levels are associated with a lower risk.
Very low and very high HDL cholesterol levels can run in families. Families
with low HDL cholesterol levels have a higher incidence of heart attacks than
the general population, while families with high HDL cholesterol levels tend to
live longer with a lower frequency of heart attacks.
Like LDL cholesterol, life style factors and other conditions influence HDL
cholesterol levels. HDL cholesterol levels tend to be lower in persons who
smoke cigarettes, are overweight and inactive, and in people with type II
diabetes mellitus.
HDL cholesterol is higher in people who are lean, exercise regularly, and do
not smoke cigarettes. Estrogen increases a person's HDL cholesterol, which
explains why women generally have higher HDL levels than men do.
For individuals with low HDL cholesterol levels, a high total or LDL cholesterol
blood level further increases the incidence of atherosclerosis and heart
attacks. Therefore, the combination of high levels of total and LDL cholesterol
with low levels of HDL cholesterol is undesirable whereas the combination of
low levels of total and LDL cholesterol and high levels of HDL cholesterol is
favorable.
What are LDL/HDL and total/HDL ratios?

The total cholesterol to HDL cholesterol ratio (total chol/HDL) is a number that
is helpful in estimating the risk of developing atherosclerosis. The number is
obtained by dividing total cholesterol by HDL cholesterol. (High ratios indicate
a higher risk of heart attacks, whereas low ratios indicate a lower risk).
High total cholesterol and low HDL cholesterol increases the ratio and is
undesirable. Conversely, high HDL cholesterol and low total cholesterol
lowers the ratio and is desirable. An average ratio would be about 4.5. Ideally,
one should strive for ratios of 2 or 3 (less than 4).
What are the treatment guidelines for low HDL cholesterol?

In clinical trials involving lowering LDL cholesterol, scientists also studied the
effect of HDL cholesterol on atherosclerosis and heart attack rates. They
found that even small increases in HDL cholesterol could reduce the
frequency of heart attacks. For each 1 mg/dl increase in HDL cholesterol,
there is a 2% to 4% reduction in the risk of coronary heart disease. Although
there are no formal NCEP (please see discussion above) target treatment
levels of HDL cholesterol, an HDL level of <40 mg/dl is considered
undesirable and measures should be taken to increase it.
How can levels of HDL cholesterol be raised?

The first step in increasing HDL cholesterol levels (and decreasing LDL/HDL
ratios) is therapeutic life style changes. When these modifications are
insufficient, medications are used. In prescribing medications or medication
combinations, doctors have to take into account medication side effects as
well as the presence or absence of other abnormalities in cholesterol profiles.
Regular aerobic exercise, loss of excess weight (fat), and cessation of
smoking cigarettes will increase HDL cholesterol levels. Regular alcohol
consumption (such as one drink a day) will also raise HDL cholesterol.
Because of other adverse health consequences of excessive alcohol
consumption, alcohol is not recommended as a standard treatment for low
HDL cholesterol.
Medications that are effective in increasing HDL cholesterol include nicotinic
acid (niacin), gemfibrozil (Lopid), estrogen, and to a much lesser extent, the
statin drugs (discussed below). A newer medicine, fenofibrate (Tricor) has
shown much promise in selectively increasing HDL levels and reducing serum
triglycerides.
http://www.medicinenet.com/cholesterol/page4.htm
Alcohol. With apologies to the American Heart Association, which discourages doctors from
telling their patients about the advantages of alcohol: one or two drinks per day can
significantly increase HDL levels. More than one or two drinks per day, one hastens to add,
can lead to substantial health problems including heart failure -- and there are individuals
who will develop such problems even when limiting their alcohol intake to one or two drinks
per day.
http://heartdisease.about.com/cs/cholesterol/a/raiseHDL.htm
High HDL & Alcohol
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High HDL & Alcohol
Overview
When you think about ways to get your cholesterol level under control, healthy eating,
abstaining from smoking and exercising regularly probably spring to mind. Yet you
may be surprised to learn that drinking alcohol may also offer cholesterol benefits,
particularly for increasing your HDL cholesterol level. Before you head off to grab
that bottle of wine, however, you need to know the risks of adding alcohol to
your diet.
Alcohol & Cholesterol Link
HDL -- high-density lipoprotein -- cholesterol is considered the good, healthy type of
cholesterol. The bad LDL form circulates in the blood and contributes to clogging of
the arteries; in contrast, HDL removes excess cholesterol from the blood so it can be
broken down by the liver. Drinking alcohol moderately -- one to two drinks a day --
can increase high-density lipoproteins, although it does not lower your LDL
cholesterol, according to the National Heart, Lung and Blood Institute. But the
University of Illinois' Dr. Karen Chapman, a registered dietitian, cautions that it's
unclear if alcohol increases the level of the specific kind of HDL most useful in
removing cholesterol from the blood.
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Potential Benefits
Keeping your LDL level in check while increasing your HDL cholesterol is an
important step in preventing heart disease and stroke. This is a major reason why
alcohol has garnered so much attention, according to Chapman; it can not only
increase high-density lipoproteins but also may help keep cholesterol and other
substances from narrowing the arteries. A February 2003 article appearing in the
"Journal of the American Medical Association" contained analysis of several studies
that discovered links between alcohol intake and stroke. Of the 35 studies reviewed,
the researchers found that those -- compared to non-drinkers -- consuming up to two
drinks a day had a 20 percent reduced risk for ischemic stroke, which is the most
common kind.
Dangers
The American Heart Association and others in the medical community stop short of
recommending alcohol to treat high cholesterol or prevent heart problems. Despite
research findings that support alcohol's positive effect on HDL cholesterol, the risks
associated with drinking are too great. Chapman says that alcohol consumption is
associated with increased triglycerides, which are fats that accumulate in the
bloodstream. Drinking alcohol also contributes to several health problems that raise
your risk for cardiovascular conditions, such as hypertension, obesity, breast cancer
and alcoholism, according to the American Heart Association. Consuming five or
more drinks a day increases your risk for ischemic stroke by 70 percent, according to
the 2003 study review.
Bottom Line
The American Heart Association's stance is that it can't endorse drinking alcohol if
you don't already consume it. The potential cardiovascular risks and the inability to
know who's at risk for alcoholism outweigh the potential benefits alcohol has on HDL
cholesterol and the arteries. If you currently drink, limit your intake to one to two
drinks a day, with the former being the limit for women. Examples of one drink
include a 12-oz. beer, 1.5-oz. 80-proof spirits and 4 oz. of wine.


Read more: http://www.livestrong.com/article/459910-high-hdl-
alcohol/#ixzz1OVMHmn4W
http://www.livestrong.com/article/459910-high-hdl-alcohol/