Men's Health: High Cholesterol Can Save Your Life

Nov. 3 -- It takes a lot to scare a man who has performed 3,000 autopsies.

But Dr. Henry McGill discovered something terrifying when he reviewed 760 postmortems of young folks between the ages of 15 and 34.

Sure, many of the bodies were mangled from violent auto wrecks and homicides. Plenty of shotgun suicides, too. But that didn’t faze him. It was their hearts.

“These autopsies found that one out of five men in their early 30s had already developed a dangerous heart blockage,” explains McGill, a pathologist at the University of Texas Health Science Center in San Antonio. “I’m talking about fatty arterial blockages that would have killed them by the time they were 45 or 50. It was shocking.”

More Dangerous Than SmokingHe made another surprising discovery: Many of the dead men with the largest blockages had a common risk factor that proved to be statistically more dangerous even than smoking: The men had low levels of high-density-lipoprotein, or HDL, cholesterol. This is the beneficial type of cholesterol that removes harmful low-density-lipoprotein (LDL) particles from your cardiac arteries before they can choke off the bloodflow.

Unfortunately, says Dr. Michael Gaziano, a cardiologist at Brigham and Women’s Hospital in Boston, few men realize how critical HDL cholesterol is in preventing fatal heart attacks and strokes. For that matter, few family doctors do, either.

“When looking over blood-test results, most men focus on their LDL cholesterol level and completely ignore the HDL cholesterol count,” he explains. “This is a huge mistake — a third of men at risk of dying of heart disease have perfectly normal levels of LDL cholesterol.” The fact is, if you don’t have enough HDL cholesterol scouring your arteries, even low amounts of LDL cholesterol can form dangerous blockages.

So how much HDL is enough? Current guidelines say 35 milligrams per deciliter of blood (mg/dl) is normal, but most cardiologists would prefer you to have an HDL count that’s twice that. “The higher the better,” says Gaziano. “Once you get over 60 mg/dl, it’s a strong positive factor in avoiding heart disease.”