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Roger S. Blumenthal, MD Responds:
Roger S. Blumenthal, MD, an associate professor of medicine and cardiology and the director of the Ciccarone Preventive Cardiology Center at Johns Hopkins University school of medicine and hospital in Baltimore, responds: Within the next five years, you may see a number of new medications that raise HDL cholesterol by as much as 50 to 80%. The drugs are now in clinical trials, and the research is promising. For now, lifestyle changes and drug therapy are your best bets for raising HDL cholesterol.
Also known as "good" cholesterol, HDL helps remove LDL (bad) cholesterol from the body. That's important because LDL can build up and form a plaque that narrows the arteries feeding blood to the heart and brain, leading to heart attack and stroke. While past research and current drug therapy have focused on lowering LDL cholesterol to prevent heart disease, consumers are likely to see a strong new emphasis on raising HDL cholesterol in the next decade. Research shows that every single milligram per deciliter increase in HDL cholesterol lowers your risk of a fatal heart attack by about 3%. To raise your HDL cholesterol:
Get active. Exercise most days of the week for at least 30 minutes, and make it brisk. Regular aerobic exercise increases HDL cholesterol by 3 to 9% in healthy sedentary adults. A strategy: Buy a pedometer to count your steps and strive for at least 10,000 steps per day. If you haven't been active recently, check with your doctor before starting an exercise program.
Quit smoking. Slap on a patch, chew nicotine gum, try counseling, or do whatever it takes to stop smoking once and for all. For some people, quitting smoking raised HDL cholesterol by 5 or more milligrams per deciliter—a sizable increase.
Lose weight. Being overweight is associated with lower HDL cholesterol. If you're overweight, talk with your doctor to determine your target weight and body mass index. Then strive to lose a pound or 2 a month through exercise and dietary changes. Replace low nutrient dense foods with more fruits, vegetables, whole grains, and healthier fats. Look for foods that are low in saturated fat and rich in polyunsaturated fatty acids such as certain oils (olive, canola, flaxseed), nuts (almonds, peanuts, walnuts, pecans), and cold-water fish (salmon, tuna).
Ask your doctor about drug options. Your doctor will be able to determine the therapy that is right for you. Just remember—you still need to maintain a healthy lifestyle—even if you're on drug therapy.
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Roger S. Blumenthal
MD
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