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Short Summary
Main recommendation: Know your LDL ("bad") cholesterol and treat it if it is high, rather than relying on HDL ("good") cholesterol as protection against heart disease. A new University of Maryland study found that raising HDL does not appear to reduce heart disease risk, so the author suggests HDL move to third place behind LDL and triglycerides when weighing cardiovascular risk. The video follows a 33-year-old Bountiful man whose Fitbit showed an elevated resting heart rate, leading to a diagnosis of dangerously high cholesterol.
Key Points
- A University of Maryland study challenges the long-held view that high HDL protects against heart attack and stroke.
- Drug developers have not been able to reduce heart disease deaths by pharmacologically raising HDL, which the study helps explain.
- Very low HDL is still considered unhealthy, but raising it with drugs has not shown benefit.
- The study's author recommends ranking HDL third, behind LDL and triglycerides, in cardiovascular risk assessment.
- The featured patient's case shows that a wearable device's elevated resting heart rate can prompt a medical visit that reveals high cholesterol.
Details Worth Noting
- Concrete instructions:
- The take-home message given was to know your LDL (bad) cholesterol level and have it managed and treated if high.
- If LDL is high, follow your doctor's treatment plan; the patient in the video took daily medication and saw his cholesterol come under control after about two weeks.
- Pay attention to wearable readings: the patient noticed a resting heart rate in the mid-80s on his Fitbit, along with fatigue, and his wife urged him to see a doctor.
- The patient, who has diabetes, was otherwise healthy at age 33. His doctor found an abnormal EKG and ordered further testing before diagnosing high cholesterol.
- When Austin asked if his diet (joking about gas station hot dogs) caused his high cholesterol, his doctor told him it was genetics.
- The video does not give specific LDL, HDL, or triglyceride numbers, nor the name of the medication.
Bottom Line
Good cholesterol is not a free pass: the priority is controlling bad cholesterol, and anyone with unexplained fatigue or an elevated resting heart rate should get checked.
