Heart attack and stroke risk individuals with diabetes can be reduce by increasing HDL cholesterol levels.
The medical records of more than 30,000 diabetes patients were examined and it was also found that individuals whose HDL cholesterol levels decreased had more strokes and heart attacks.
Individuals with diabetes are more prone to heart disease with a lifetime risk as high as 87%. While there is considerable evidence that the reduction of LDL cholesterol can reduce the risk of heart disease, the relationship between HDL cholesterol and heart disease is less clear.
The patients had at least 2 HDL cholesterol measurements between 6 and 24 months apart. No significant change in HDL cholesterol levels was observed in 61% of individuals; in 22% of individuals, HDL cholesterol levels increased by at least 6.5 mg/dl; in 17% of individuals, HDL cholesterol levels decreased by at least that same amount. The individuals were then followed for up to 8 years to see if they were hospitalized for a stroke or heart attack. Individuals whose HDL cholesterol levels increased had 8% fewer strokes and heart attacks compared to individuals whose HDL cholesterol levels stayed the same, while individuals whose HDL cholesterol levels decreased had 11% more strokes and heart attacks. This study was observational so there was no intervention to change HDL cholesterol levels, and although a lot of individuals were on statins for LDL cholesterol reduction, not many were on medications for improving HDL cholesterol.
Previous studies on this topic have had contradictory results. A 2009 study revealed that for every 5 mg/dl improvement in HDL cholesterol level individuals saw a 21 % decrease in heart attack risk. But a 2009 systematic review of over 100 clinical trials revealed that the increase of HDL cholesterol didn’t reduce the risk of heart disease or death.
HDL cholesterol levels can be increased without medication by change in diet, keeping weight down, increasing exercise and avoiding tobacco smoke. It’s believed that HDL cholesterol carries LDL cholesterol away from the arteries and back to the liver where it’s processed and eliminated from the body. The American Diabetes Association recommends a minimum of 50 mg/dl of HDL cholesterol for women and a minimum of 40 mg/dl for men. Levels of 60 mg/dl or higher are believed to protect against heart disease.