Heart Month: More to cholesterol than “good” and “bad”

By: Allison Hydzik

Research out of the University of Pittsburgh Graduate School of Public Health may hold the key to the failure of four high-profile clinical trials involving drugs that raise so-called “good” cholesterol.


Pitt epidemiologist Rachel Mackey, Ph.D., has found evidence that drugs that increase HDL cholesterol – often called “good” cholesterol to differentiate it from LDL “bad” cholesterol – likely aren’t working to reduce cardiovascular disease risk because the approach they use is too simplistic. 


“Cholesterol is carried to the liver for removal from the body on particles known as lipoproteins,” said Dr. Mackey. “These failed drugs raised levels of HDL cholesterol carried by these HDL particles, but not the actual number of particles. My research suggests that you need to raise the number of HDL particles to lower carotid atherosclerosis and heart disease risk.” 

Dr. Mackey’s articlereporting her findings in the Journal of the American College of Cardiology (JACC) has been selected by the journal’s editors as one of the top papers of the year for its significant impact on the field of cardiology.
It has also been cited in editorials in Nature Medicine (“The not-so-simple HDL story”), JACC(“A Better Measure to Quantify High-Density Lipoprotein?”), and twice in Nature Reviews Cardiology (“HDL cholesterol studies – more of the same?”  and “HDL cholesterol is not HDL – don’t judge the book by its cover”). � 

At the end of May, Dr. Mackey will be giving an invited lecture on “HDL Particles and Coronary Heart Disease Risk” at theNational Lipid Association Annual Scientific Sessions conference in Las Vegas. 

For more information, read the Pitt Schools of the Health Sciences press release and Pittsburgh Quarterly article “The cholesterol conundrum” featuring Dr. Mackey’s research and watch a video about her  work.