Does cholesterol protect women of all ages against cardiovascular diseases?

Protective effect of HDL not given in all women

Postmenopausal factors can affect the heart-protective properties of high-density lipoproteins (HDL), which are often referred to as good cholesterol. Thus, this specific type of cholesterol does not protect older women from cardiovascular disease.

Researchers at the University of Pittsburgh's Graduate School of Public Health found in their recent research that so-called good cholesterol does not seem to protect postmenopausal women from cardiovascular disease. The physicians published the results of their study in the English language journal "Arteriosclerosis, Thrombosis, and Vascular Biology".

How does HDL normally protect the heart??

HDL are particles that circulate in the blood and differ in size and cholesterol content. Earlier research had already revealed that HDL seems to protect the heart. This so-called good cholesterol transports fats away from the heart, reduces the build-up of plaque and reduces the risk of cardiovascular disease.

HDL can mask the risk of heart disease

The findings of the study are of interest to both the public and experts, as overall HDL cholesterol is still used to predict cardiovascular disease risk, says study author Dr. Samar R. El Khoudary of the University of Pittsburgh. The current study confirms earlier work on a different group of women and suggests that physicians need to further investigate the nature of HDL in middle-aged and older women, as higher HDL cholesterol may not be protective of cardiovascular disease in post-menopausal women has, the expert continues. High total HDL cholesterol in postmenopausal women could mask a significant risk of heart disease.

More than 1,100 subjects were examined for the study

The researchers studied a total of 1,138 women between the ages of 45 and 84 who participated in the multiethnic study of atherosclerosis (MESA) in the United States. The results suggest that the traditional measure of good cholesterol (HDL cholesterol) does not allow a precise presentation of the risk of heart disease for postmenopausal women.

Women undergo physiological changes during menopause

Women are subject to a variety of physiological changes in their sex hormones, lipids, body fat deposits, and vascular health during menopause. The study authors hypothesize that the decline in estrogen along with other metabolic changes over time can trigger chronic inflammation that alters the quality of HDL particles. Previous studies have already found an unexpected relationship between HDL cholesterol and postmenopausal women, but they have never been researched more accurately, say the experts.

HDL cholesterol is not always cardioprotective?

The current study examined two specific measurements of HDL. From this, the researchers concluded that HDL cholesterol is not always cardioprotective in postmenopausal women. The harmful association of elevated HDL cholesterol with the risk of atherosclerosis was most evident in women who had started menopause ten or more years ago.

Different effects of HDL

In addition, a high number of small HDL particles proved beneficial for postmenopausal women. These findings exist regardless of age. On the other hand, large HDL particles are associated with an increased risk of cardiovascular disease around the onset of menopause. During this time, the quality of HDL can be reduced, increasing the likelihood that women will develop atherosclerosis or cardiovascular disease. If the onset of menopause lasts longer, the quality of the HDL can recover, so the good cholesterol is cardioprotective again, explain the authors. (As)