Cholesterol Archive

The scientific understanding of HDL cholesterol has evolved in recent years, and many cardiologists now believe that HDL may be more of a bystander rather than a "good guy" that helps lower heart disease risk. While some types of HDL are great at plucking excess cholesterol from LDL and artery walls (a process referred to as reverse cholesterol transport) other types of HDL don't do this. In clinical trials, medications to raise HDL levels—including a drug specifically designed to improve reverse cholesterol transport—have not succeeded in lowering heart attacks and strokes.

People can reduce their LDL cholesterol in three ways. One strategy involves dietary changes, such as eating more fiber-rich foods and swapping saturated fats for unsaturated fat. Another is to take one of several dietary supplements, including psyllium, plant sterols, or red yeast rice. The third entails taking a prescription medication, such as a statin. Many factors can affect whether these different strategies are advisable or useful, including a person's age and other risk factors for heart disease, their current dietary habits, and the quality of the supplements they take.

Studies have shown a link between lower risks of cardiovascular disease, some cancers, and even dementia in people who consume higher amounts of olive oil. However, no definitive studies show extra-virgin olive oil has greater benefits than regular olive oil.

Using a Web-based app, most people can correctly assess their need for a cholesterol-lowering statin and take the drug appropriately with good results, according to a 2024 study. If approved, the app could facilitate statin use without a doctor's prescription.

A 2024 study found that people with high blood sugar and high triglycerides are more likely to develop chronic stress, anxiety, or depression later in life, compared with people who have low or normal blood sugar levels.

People who are at high risk for cardiovascular disease can benefit from driving down "bad" low-density lipoprotein (LDL) cholesterol levels as low as possible to help reduce their risk for heart attacks and strokes. Guidelines recommend that people at high risk aim for LDL levels below 70 milligrams per deciliter (mg/dL). The general population should strive for levels below 100 mg/dL. Taking statins and adopting healthier lifestyle habits like following a plant-based diet and increasing exercise can help manage LDL levels.

High-dose niacin (vitamin B₃) is no longer recommended to improve cholesterol and triglyceride levels. Different forms of niacin, such as niacinamide (nicotinamide), are sold as supplements; the potential benefits and risks remain unclear.

According to a 2024 review, the ketogenic (keto) diet—which is high in fat and protein and low in carbohydrates—doesn't meet standards for a healthy diet and may not be safe for some people with heart disease.

Up to 30% of Americans have above-normal levels of triglycerides, which many studies have linked to a higher risk of heart disease. Lifestyle changes that can lower triglycerides include losing weight if needed; avoiding simple carbohydrates, sweets, and alcohol; cutting back on saturated fats; and doing regular exercise. For people whose levels remain high (especially those at risk for heart disease), medications such as fibrates or icosapent ethyl (Vascepa) may be helpful.