Issue Date: August 24, 2008
New tests for cholesterol
You can now go beyond LDL and HDL to tailor medication.
Some "good" cholesterol turns out to be bad for your heart.
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These days, we're used to thinking about cholesterol in terms of LDL (the bad kind) and HDL (the good kind). Analysis of these components has helped doctors prescribe medications for heart patients. But medicine is ever-changing, and now labs can offer more sophisticated analysis that identifies different types of LDL and HDL.
This new analysis shows, for example, that not all LDL cholesterol is the same. Some LDL particles are large, fluffy structures that don't contribute to heart disease. Other LDL particles are small, dense and a significant risk factor for coronary disease. All HDL cholesterol -- and triglycerides -- isn't the same. HDL, for instance, is not as uniformly protective as we would like to think.
Understanding these additional pieces of the puzzle helps to explain why treating just HDL, LDL or triglycerides doesn't always work. I see more physicians assessing these smaller subcategories to help them decide what medications may be the most beneficial. The next time you see your doctor, ask about the new cholesterol subcategory tests.
Tedd Mitchell, M.D., presidentand CEO of Dallas' Cooper Clinic, writes HealthSmart every week.
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