Good Cholesterol: When Does HDL Become Harmful?
- Contrary to popular belief, some forms of "good" cholesterol, or high-density lipoproteins (HDL), might be linked to a higher risk of cardiovascular disease, according to Houston Methodist researchers.
- Pownall noted that routine cholesterol tests measure both "bad" (LDL) and "good" (HDL) cholesterol.
- Initial studies indicate that HDL with elevated free cholesterol is highly likely dysfunctional.
Contrary to popular belief, the “good” cholesterol (HDL) may not always be heart-healthy. Research from Houston Methodist reveals that specific properties of high-density lipoproteins may elevate cardiovascular disease risk. The study pinpoints high free cholesterol content within HDL as a potential factor contributing to dysfunction. This research, led by Dr. Henry J. Pownall and Dr. Khurram Nasir, aims to understand how HDL impacts heart health, challenging the conventional wisdom around cholesterol management. The team is currently analyzing data from 400 patients. Their findings indicate that free cholesterol transfer from HDL to white blood cells might increase cardiovascular disease risk. News Directory 3 has the latest on this critical research. The researchers are aiming to create new diagnostics and therapeutic solutions within six years, using HDL-free cholesterol as a key biomarker. Discover what’s next in the fight against heart disease.
Study: HDL cholesterol May Increase Heart Disease risk
Updated June 7, 2025
Contrary to popular belief, some forms of “good” cholesterol, or high-density lipoproteins (HDL), might be linked to a higher risk of cardiovascular disease, according to Houston Methodist researchers. The team, led by Dr. Henry J. Pownall and Dr. Khurram nasir, is exploring the specific properties of HDL and their impact on heart health.
Pownall noted that routine cholesterol tests measure both “bad” (LDL) and “good” (HDL) cholesterol. He added that cholesterol exists in two forms: free cholesterol, which is active, and esterified cholesterol, which is stored.Too much free cholesterol, even within HDL, could be detrimental.
Initial studies indicate that HDL with elevated free cholesterol is highly likely dysfunctional. The researchers are currently studying 400 patients in the NIH-funded Houston Heart Study to confirm these findings across varying plasma HDL concentrations.
Pownall said the study’s moast surprising finding is the strong correlation between free cholesterol in HDL and its accumulation in macrophages, white blood cells that can contribute to heart disease.
While HDL was thought to benefit heart health by removing excess cholesterol, the data suggests that high plasma HDL concentrations may reverse this effect. Free cholesterol transfer from HDL to white blood cells could increase cardiovascular disease risk.
“The most surprising finding from our study thus far is that there is a strong link between the amount of free cholesterol in HDL and how much of it accumulates in white blood cells called macrophages, which can contribute to heart disease,” Pownall said.
What’s next
The researchers plan to develop new diagnostics and treatments for heart disease, using HDL-free cholesterol as a biomarker to identify patients who may benefit from HDL-lowering therapies. Pownall anticipates clinical applications within six years, potentially utilizing existing drugs that affect free cholesterol.