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Health and Medicine

Cleveland study explains how 'good' cholesterol turns bad
Inflammation in the arteries causes the oxidation of HDL, which then contributes to plaque formation instead of reducing it

Reporter / Host
Jeff St. Clair
Dr. Stanley Hazen is director of the Center for Cardiovascular Diagnostics & Prevention at the Cleveland Clinic. His latest study details how inflammation causes 'good' HDL to change into a form that contributes to heart disease.
Courtesy of Jeff St.Clair
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Researchers at the Cleveland Clinic have found that not all supposedly ‘good’ cholesterol is really good. Their study released Sunday also explains why simply raising your levels of good cholesterol doesn’t lead to better heart health.

WKSU’s Jeff St.Clair reports that the findings may change the testing and treatment of heart disease.

LISTEN: Inflammation and dysfunctional HDL

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For years we’ve been told that HDL or high density lipoprotein is the good type of cholesterol and LDL or low density lipoprotein is the ‘bad’ cholesterol.

But researchers at the Cleveland Clinic have discovered that not all HDL is good. And their findings help explain why drugs designed to raise levels of HDL don’t prevent heart disease.

Stanley Hazen led the study.  He says inflammation in the arteries changes the HDL from good to bad. Products of an inflammatory enzyme, myeloperoxidase, are now shown to selectively target the main protein in HDL.

“And it turns it into not a protective form but a harmful or dysfunctional form.”

And that dysfunctional HDL, instead of removing cholesterol from the arteries, adds to its buildup. Hazen says the discovery adds further proof that heart disease is linked to inflammation.

“It’s like trying to separate the grease from a grease fire, you need the oil and grease to keep the fire going but there’s something that has to be providing the heat. The heat itself is the inflammation, the cholesterol and the lipid is the fuel, and that’s why there so intertwined.”

Hazen and his team are developing tests to identify ‘bad’ HDL, and new therapies to prevent its formation.

The five year study looked at more than 600 patients at the Cleveland Clinic. The results appear in the latest edition of Nature Medicine. 

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