Most people fixate on the wrong number in the cholesterol equation for reducing the risk of cardiovascular disease (CVD). It actually may be more important to know if your good HDL cholesterol is too low (<40 for men, <50 for women) than if your bad LDL cholesterol is too high. This is the current opinion from the field of lipidology, and corroborated by the Framingham coronary prediction algorithm.

The reason LDL has attracted so much attention is because there are more effective drug options for lowering LDL than for raising HDL. Statins are usually the drugs of choice for reducing LDL levels, but are generally not effective in raising HDL more than 6 percent, or higher with some statins, but only in very high doses. And they may create unwanted side effects -- like muscle and joint pains, and depleting CoQ10 from the body, which can actually increase the risk of CVD. Perfectly low LDL levels do not guarantee immunity from strokes and heart attacks.

"Raising HDL is definitely the new frontier in the battle to eliminate the risk of cardiovascular disease," said cardiologist Dennis Goodman, MD, FACC, FACP, FCCP, a member of the physician team at Scripps Center for Integrative Medicine. "It's no coincidence that Pfizer invested nearly $1 billion to develop Torcetrapib for raising HDL, which unfortunately had disappointing results that terminated the project."

Dr. Goodman's study, presented at the 4th Annual Natural Supplements Conference: An Evidence-Based Update (January 19-21) at the Hilton La Jolla Torrey Pines, followed the progress of 50 patients (29 females, 21 males) with at least one risk factor for coronary artery disease in addition to abnormal lipids. The patients were administered a novel cardio-friendly nutriceutical formula that raised HDL by an average of 20 percent, with greater increases for those with HDL <40. HDL2, considered the best type of HDL, increased by 28 percent, and total cholesterol to HDL ratio decreased by 11 percent, while high sensitivity C-reactive protein (hsCRP) decreased by 27 percent and by 34 percent for those with elevated hsCRP at baseline. Patients had an average decrease in triglycerides of 33 percent, and a drop in homocysteine levels by 12 percent.

The HDL Booster dietary supplement used in the study (two capsules twice daily) consisted of: vitamins C, E, B6, B12, niacin (low dose, 40 mg/day), and folic acid; minerals magnesium and selenium; and supplements coenzyme Q10, policosanol, L-carnitine, L-arginine, N-acetylcysteine, alpha lipoic acid, tocotrienols, soy isoflavones, taurine, and the herbal extracts of hawthorn (Crategus oxyacantha) berry, garlic (Allium sativum), grape (Vitis vinifera) seed extract, and grape (Vitis vinifera) skin extract.

"We're excited by the implications of this study but more research must be done. We plan to embark on a randomized, controlled trial in the next few months," said Dr. Goodman. "Unlike niacin preparations, today's most widely prescribed drugs for raising HDL, HDL Booster has negligible untoward side effects, and therefore compliance will be much higher." Approximately 25-30 percent of patients stop taking pharmaceutical niacin because of uncomfortable flushing.

"For every 1 point (mg/dl) increase in HDL, there is a 2 percent decrease in cardiovascular risk (including heart attacks and strokes) for men and 3 percent for women," explained Goodman. "Therefore, it is important to focus on both lowering LDL and raising HDL cholesterol (in addition to other risk factors like high blood pressure, smoking, diabetes, obesity, etc.) to achieve the lowest possible cardiac risk. And if you can do it naturally through proper diet, exercise and supplementation, it's definitely the best way to go." For more information, visit http://www.dennisgoodmanmd.com/.