Study finds beefy 'good' cholesterol may increase heart attack risk

Health experts have long advised their patients to make dietary changes that reduce their LDL 'bad' cholesterol while increasing their HDL 'good' cholesterol. However, studies have shown a bit of paradox in the sense that raising HDL cholesterol doesn't necessarily reduce heart disease risk — and the reason, according to the latest research, may be problems associated with big versus small cholesterol particles.

Put simply, 'bad' LDL cholesterol is the kind that causes a build-up in the arteries, putting someone at risk of heart disease and related issues. 'Good' HDL cholesterol, meanwhile, shuttles cholesterol from the arteries to the liver for elimination.

Elevated HDL cholesterol doesn't necessarily offer protection, however, according to a new study from Hospital del Mar Medical Research Institute. The benefit or risk depends on the HDL cholesterol's size, with large particles linked to an increased risk of suffering a heart attack.

The study's principal investigator Dr. Robert Elosua explained:

There is a positive causal relationship between the size of HDL cholesterol particles and the risk of heart attack, so although we have to increase the levels of good cholesterol in the blood, they must always be small particles.

The small HDL cholesterol particles are able to effectively gather up cholesterol from arteries and carry it off to the liver. While the study has paved the way for additional research, there currently aren't any drugs that increase 'good' cholesterol levels, let alone ones that result in small particles.