We, as physicians, always tell our patients that the goal is to lower their LDL (bad cholesterol) and raise their HDL (good cholesterol).

Why is HDL considered the good cholesterol, and why is it so important?

The cardioprotective effects of HDL are strongly suggested by the consistent inverse relationship between HDL levels and the risk of coronary artery disease (CAD).

When HDL is high, the risk of CAD is lessened. For example, when one eats a fatty meal, the food is broken down resulting in LDL depositing in the coronary arteries (the pipes that feed the heart). Over time, plaque builds up and the risk of heart attack increases.

On the other hand, HDL is made in the liver and one of its main functions is to pull the cholesterol out of plaques. By removing the cholesterol, HDL is also getting rid of the inflammatory stimulus therefore allowing for plaque healing.

In addition, HDL possesses anti-oxidant capabilities. Plus, studies have shown that HDL promotes plaque shrinkage or regression making HDL a therapeutic target.

So, one may wonder how do I raise my HDL?

Firstly, for those who smoke, please quit. Smoking leads to plaque build-up and decreases HDL function.

Secondly, exercise regularly.

Lastly, eating a healthy diet is the mainstay of treatment. Eating your vegetables and staying away from too many carbohydrates is certainly a start. A diet rich in omega-3-fatty acids (fish such as wild salmon) has also been shown to be beneficial.

Also, research has also demonstrated that an occasional glass of red wine can increase HDL function.

If all of the above does not help, there are drugs such as niacin that can raise HDL. However, the use of this agent is somewhat controversial given recent reports that do not demonstrate its long term beneficial effects.

It should be mentioned that statins such as Lipitor or Crestor can mildly raise HDL. However, the major use of statin medication is for the reduction of the bad cholesterol, LDL.

Nevertheless, stay tuned for more research regarding the hunt for new agents that can raise HDL levels and function.

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Annapoorna Kini, MD, is Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital and Professor of Cardiology, Medicine at Icahn School of Medicine at Mount Sinai.