Protective effect of HDL is not given in all women
Postmenopausal factors can affect the cardio-protective properties of high-density lipoproteins (HDL), which are often referred to as good cholesterol. This specific type of cholesterol does not protect older women from cardiovascular diseases.
The University of Pittsburgh Graduate School of Public Health scientists found in their current study that so-called good cholesterol does not appear to protect postmenopausal women from cardiovascular disease. The doctors 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. Previous research had shown that HDL appeared to protect the heart. This so-called good cholesterol transports fats away from the heart, reduces the build-up of plaque and lowers the risk of cardiovascular diseases.
HDL can mask the risk of heart disease
The results of the study are of interest to both the public and experts, as total HDL cholesterol is still used to predict cardiovascular disease risk, says study author Dr. Samar R. El Khoudary from the University of Pittsburgh. The current study confirms previous work on another group of women and suggests that doctors need to examine the type of HDL in middle-aged and older women more closely, since higher HDL cholesterol may not have a protective effect on cardiovascular diseases in postmenopausal women the expert continues. High total HDL cholesterol in postmenopausal women can mask a significant risk of heart disease.
Over 1,100 subjects were examined for the study
For their study, the scientists examined a total of 1,138 women aged 45 to 84 who participated in the multi-ethnic study on atherosclerosis (MESA) in the United States. The results indicate that the traditional measure of good cholesterol (HDL cholesterol) does not provide an accurate picture of the risk of heart disease for postmenopausal women.
Women experience physiological changes during menopause
Women are subject to a variety of physiological changes in their sex hormones, lipids, body fat deposition and vascular health during menopause. The study authors hypothesize that the decline in estrogen along with other metabolic changes over time can cause chronic inflammation that changes the quality of HDL particles. Previous studies have found an unexpected relationship between HDL cholesterol and postmenopausal women, but it has never really been explored, the experts say.
HDL cholesterol not always cardioprotective?
The current study examined two specific measurements of HDL. The researchers concluded that HDL cholesterol is not always cardioprotective in postmenopausal women. The damaging 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 large number of small HDL particles were found to be 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 diseases around the start 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 is longer ago, the quality of the HDL can be restored, and the good cholesterol becomes cardioprotective again, the authors explain. (as)