Written by: Dr. Greg 
Ever since cholesterol was linked to heart disease, we have been told that LDL is the “bad cholesterol” that leads to heart attack and HDL is the “good cholesterol”. While this oversimplification has some merit to it, there is much more to the story than meets the eye. Let’s break down LDL and HDL a little further to understand exactly why neither is actually good or bad, just different, and why elevated LDL is a horrible predictor of heart attack risk.
LDL, or low-density lipoprotein, gets its “bad cholesterol” label due to its ability to form plaque on the arterial walls, which can clog the arteries and lead to heart attack. While long-term plaque accumulation is dangerous to your health, it doesn’t automatically mean LDL is always bad. LDL is also responsible for a number of incredibly beneficial functions including:
- steroid hormone formation
- immune system support
- wound healing
- fighting infection
- brain and memory function
And that’s just to name a few. When LDL levels go up, it means that the body needs it for a very specific reason and it must be elevated to fix the problem. The body simply doesn’t make mistakes!
To counter-act the plaque formation from the LDL, the body sends HDL, or high-density lipoprotein, to the sight of plaque accumulation to remove it and take it to the liver to get rid of it. HDL is like the garbage truck that goes around the body picking up the trash. When LDL levels are elevated, HDL acts as a buffer to make sure plaque formation doesn’t get out of hand. In this way, LDL and HDL work together to try to keep the body at “normal” function.
The Real Culprit
HDL and LDL are both important, and they both have very different roles. If LDL was truly the “bad guy” is has been made out to be, we would see a correlation between elevated LDL levels in relation to heart attacks, right? However, that is not the case. In fact, one study demonstrated that only 50% of patients with heart attacks had elevated LDL levels (>100 mg/dl)1 . Would you consider something reliable if it only worked half the time? No – especially when it comes to your heart! LDL levels are a horrible indicator of heart attack risk!
What, then, is a reliable indicator of risk? Inflammation. Inflammation is what actually determines your level of heart attack risk. It interferes with the ability of LDL and HDL to do their jobs. It weakens the arterial walls and makes the body more susceptible to the plaque rupture that leads to a heart attack. Unless you determine the level of inflammation present, you cannot accurately measure heart attack risk.
In order to reverse the heart disease epidemic, we need to erase the years of misinformation about LDL and HDL. They are both important, and they are both necessary. They aren’t to blame for the heart disease epidemic. The basic lipid testing and recommendations made by your traditional healthcare provider is going to fall short of what you really need to know. What you need to know, and what you need to address, is the issue of inflammation. We are happy to tell you more! The Wellness Way hosts dinners all over the country on the topic of inflammation every single week. Check for one near you and become empowered to break stigmas and take control of your health!