Dec 22, 2012
Cholesterol comes not only in the good (or HDL) and the bad (LDL), but also in large and small particles.
"Large cholesterol particle size … seems to protect them from a variety of age-related diseases such as heart diseases, hypertension and diabetes," said Dr. Nir Barzalai of the Albert Einstein College of Medicine in New York, author of a recent study on particle size published in the Journal of the American Medical Association.
Researchers suspect that inside blood vessels, the larger, so-called fluffier cholesterol particles are able to pass more easily. Smaller, denser particles tend to cling to artery walls, which leads to the buildup of plaque and an increased risk of a heart attack or stroke.
An Increasingly Important Distinction
Normally, people focus on their total cholesterol level. But studies show that even among people with the same cholesterol level, those who have lots of large cholesterol particles have only about a third the risk of having a heart attack as those who have mostly small particles.
A handful of labs in the United States now measure blood for particle size. And some doctors are now recommending the test to patients who have a strong family history of heart disease and other risk factors but have only borderline cholesterol levels.
"It's extremely helpful to show them these abnormalities in particle size so they understand why they are at higher risk and why they should be treated," said Dr. Ronald Krauss of the University of California-Berkeley and a researcher in cholesterol particle size.
Doctors say you can make your cholesterol particles larger through a low-carbohydrate diet, exercise and medications, including niacin. Researchers are already working on a drug that would both lower cholesterol levels and increase particle size.
It's yet another way to improve the odds of living a longer life.