Increasing Levels of Good Cholesterol Can Reduce Heart Attack Risk in Diabetes Patients

Patients with diabetes may be able to reduce their risk of heart attack and stroke by increasing their level of high-density lipoproteins (HDL), also known as the “good” cholesterol. That’s the take-home message of a new study from the Kaiser Permanente Center for Health Research (CHR).

The study, which examined the medical records of more than 30,000 patients with diabetes, appears online in the October issue of The American Journal of Cardiology. The lead author is CHR senior investigator Gregory Nichols, PhD.

Dr. Nichols and his team found that patients whose HDL levels increased by at least 6.5 mg/dl (milligrams per deciliter of blood) had an 8 percent reduced risk of heart attacks and strokes than patients whose HDL levels remained the same. In contrast, patients whose HDL levels went down by 6.5 mg/dl had an 11 percent increased risk of heart attacks and strokes.

People with diabetes are especially prone to heart disease, with a lifetime risk as high as 87 percent, according to a paper from the landmark Framingham heart study published in 2008. Many diabetes patients already take a statin drug to reduce their low-density lipoprotein (the “bad” cholesterol) levels, a proven strategy for reducing the risk of heart problems. This new paper focused on HDL because there is less evidence that changes in this type of cholesterol can affect heart risk.

“There are relatively few drugs on the market to affect HDL levels, and many people can’t tolerate the side effects,” says the paper’s co-author, Suma Vupputuri, PhD, an Atlanta-based CHR investigator.

Dr. Vupputuri adds, “The safest way to raise our ‘good’ cholesterol levels is to increase exercise, improve nutrition, and stop smoking.”

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