The Garbage Trucks in Your Blood

Dr. Steven Nissen at the Cleveland Clinic is conducting a study using a new, sophisticated measure of coronary-artery blockages called intravascular ultrasound to determine if torcetrapib affects plaque buildup in the coronary arteries. That study will be reported in March at the American College of Cardiology annual scientific sessions.

There are other drugs in development like torcetrapib that raise HDL, but until the reason for these excessive deaths is well understood, they are not likely to reach the market, and this may take many years.

In the meantime, if you have a low HDL level, what else can you do to raise HDL that is good for you rather than harmful?

1. Lower your LDL cholesterol. It's easier to lower LDL than raise HDL. I think there should be less emphasis on raising HDL and more on lowering LDL via diet and lifestyle or, as a second choice, with lipid-lowering drugs. If you reduce your LDL below 100 mg/dl, or even lower if you have coronary heart disease, then your HDL level will be much less important.

If you don't have heart disease, you can begin by making moderate changes in your diet, such as recommended by the American Heart Association and the National Cholesterol Education Program: eat less red meat, more fish and chicken, less than 30 percent of calories from fat. Replace saturated fat with monosaturated fat. If that's enough to lower your LDL sufficiently, great; if not, then you can make progressively bigger reductions in saturated fat, trans fatty acids, total fat, dietary cholesterol and refined carbohydrates, and eat more fruits, vegetables and other whole foods in their natural forms. These dietary changes will not only lower your LDL, they will help prevent other chronic diseases and also help you to look better, feel better, lose weight and gain health.

If you are not interested in changing your diet to this degree, then consider taking lipid-lowering drugs that your doctor may prescribe, including statin drugs such as Lipitor or Zocor. Some studies suggest that taking coenzyme Q10 with statin drugs may help prevent some of the adverse side effects in muscles.