How to Increase Good Cholesterol (HDL)? Unfortunate Demise of the Pfizer Drug
HDL is an acronym for high density lipoprotein. It is also called good cholesterol. It can be measured by doing a fasting blood test called lipid profile. HDL acts as a friendly scavenger, so higher HDL is protective against blockage of heart arteries. Low HDL is a strong predictor of blockages of heart arteries. The desirable level for HDL is 40 or above. One of the reasons that we tend not to be very aggressive about increasing HDL is that we do not have many easy and good options to deal with this problem.
Few years ago, a study published in the Journal of American Medical Association talked about Apo A-1 Milano that had caused regression of coronary artery disease (blockages in the heart arteries). This was great news. Short of curing the problem of blockages in the heart arteries, having something like a Drano for the heart arteries will be the most important development in the field of cardiology. Around the time of publication of that study, I had Dr. P. K. Shah, an authority on Apo A-1 Milano on my radio show.
Pfizer came pretty close to filling the need for an HDL enhancing drug. Unfortunately, their drug Torcetrapib recently had to be taken out of contention due to excessive deaths among research volunteers taking this medicine.
So what are the measures that can increase HDL?
1. Aerobic exercises like walking, swimming, bike riding and jogging.
2. Weight loss.
3. Smoking cessation.
4. Cutting ingestion of trans fats can increase HDL. Trans fats are found in abundance in fats that are solid at room temperature. The fats described as “hydrogenated oils” on the food packages have lots of harmful trans fats. New York City recently took the lead in banning use of trans fats in the city restaurants.
5. One or two drinks of alcohol daily can increase HDL. There is however, a down side to prescribing alcohol as an HDL enhancing measure. One of the possible problems is alcohol’s addiction potential.
6. There are good fats and there are bad fats. The good kind monounsaturated fats such as canola oil, avocado oil, olive oil and those found in peanut butter can help increase HDL. A word of caution: very low fat diets are known to lower HDL and too much of any fat increases calorie content which can lead to weight gain. The later in turn can decrease HDL.
7. Fibers found in oats, fruits, vegetables and legumes can help increase HDL.
8. The statins like Pravastatin, Simvastatin, Lovastatin, Crestor and Lipitor as a general rule are not good HDL enhancers. High doses of a B group vitamin called Niacin can help increase HDL. The patient acceptance however continues to be a challenge due to side effects like flushing and itching after taking this drug. Some tips on decreasing the chance of side effects from niacin are: taking an aspirin 30-60 minutes before taking niacin, taking niacin at night and avoiding high fat diet at night. Some long-acting niacin manufacturers claim fewer side effects as compared to short-acting niacin.
I am discouraged by the news of unfortunate demise of a promising HDL enhancing drug from Pfizer. But I am very happy to see oversight of research trials (that should assure safety of research volunteers) at work. I think a good, effective and well tolerated HDL enhancing drug will lead to a new phase of aggressive management of low HDL. Short of that, we should focus hard on HDL enhancing measures stated above. All these measures are not only good for increasing good cholesterol, but are also good for our overall wellbeing.
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Few years ago, a study published in the Journal of American Medical Association talked about Apo A-1 Milano that had caused regression of coronary artery disease (blockages in the heart arteries). This was great news. Short of curing the problem of blockages in the heart arteries, having something like a Drano for the heart arteries will be the most important development in the field of cardiology. Around the time of publication of that study, I had Dr. P. K. Shah, an authority on Apo A-1 Milano on my radio show.
Pfizer came pretty close to filling the need for an HDL enhancing drug. Unfortunately, their drug Torcetrapib recently had to be taken out of contention due to excessive deaths among research volunteers taking this medicine.
So what are the measures that can increase HDL?
1. Aerobic exercises like walking, swimming, bike riding and jogging.
2. Weight loss.
3. Smoking cessation.
4. Cutting ingestion of trans fats can increase HDL. Trans fats are found in abundance in fats that are solid at room temperature. The fats described as “hydrogenated oils” on the food packages have lots of harmful trans fats. New York City recently took the lead in banning use of trans fats in the city restaurants.
5. One or two drinks of alcohol daily can increase HDL. There is however, a down side to prescribing alcohol as an HDL enhancing measure. One of the possible problems is alcohol’s addiction potential.
6. There are good fats and there are bad fats. The good kind monounsaturated fats such as canola oil, avocado oil, olive oil and those found in peanut butter can help increase HDL. A word of caution: very low fat diets are known to lower HDL and too much of any fat increases calorie content which can lead to weight gain. The later in turn can decrease HDL.
7. Fibers found in oats, fruits, vegetables and legumes can help increase HDL.
8. The statins like Pravastatin, Simvastatin, Lovastatin, Crestor and Lipitor as a general rule are not good HDL enhancers. High doses of a B group vitamin called Niacin can help increase HDL. The patient acceptance however continues to be a challenge due to side effects like flushing and itching after taking this drug. Some tips on decreasing the chance of side effects from niacin are: taking an aspirin 30-60 minutes before taking niacin, taking niacin at night and avoiding high fat diet at night. Some long-acting niacin manufacturers claim fewer side effects as compared to short-acting niacin.
I am discouraged by the news of unfortunate demise of a promising HDL enhancing drug from Pfizer. But I am very happy to see oversight of research trials (that should assure safety of research volunteers) at work. I think a good, effective and well tolerated HDL enhancing drug will lead to a new phase of aggressive management of low HDL. Short of that, we should focus hard on HDL enhancing measures stated above. All these measures are not only good for increasing good cholesterol, but are also good for our overall wellbeing.
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posted by kc at 3:55 PM
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