Rethinking HDL cholesterol

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.