"Good" Cholesterol's Role Questioned.

• Position: HEART HEALTH

High-density lipoprotein (HDL) cholesterol, often called the "good cholesterol," may not be as effective as scientists once believed in uniformly predicting cardiovascular disease risk among adults of different racial and ethnic backgrounds. The research, published in the Journal of the American College of Cardiology, found that while low levels of HDL cholesterol predicted an increased risk of heart attacks or related deaths for white adults--a long-accepted association--the same was not true for black adults. Additionally higher HDL cholesterol levels were not associated with reduced cardiovascular disease risk for either group.

"The goal was to understand this long-established link that labels HDL as the beneficial cholesterol, and if that's true for all ethnicities," says Nathalie Pamir, senior author of the study and associate professor of medicine within the Cardiovascular Institute at Oregon Health & Science University, Portland. "It's been well accepted that low HDL cholesterol levels are detrimental, regardless of race. Our research tested those assumptions."

To do that, Pamir and her colleagues reviewed data from 23,901 U.S. adults who participated in the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS). Previous studies that shaped perceptions about "good" cholesterol levels and heart health were conducted in the 1970s through research with a majority of white adult study participants. For the current study researchers were able to look at how cholesterol levels from black and white middle-aged adults without heart disease who lived throughout the country overlapped with future cardiovascular events.

The study was the first to find that lower HDL cholesterol levels only predicted increased cardiovascular disease risk for white adults. It also expands on findings from other studies showing that high HDL cholesterol levels are not...