So what’s going on? No one is arguing against the evidence that a high HDL is associated with a reduced risk of heart disease in normal persons, because it clearly is. But maybe the high HDL is not directly causing the reduced risk. (Remember, an association does not prove cause/effect.) And if a high HDL isn’t directly protective, then raising LDL through drugs or other means would be unlikely to be beneficial.
Incidentally, the same may not be true for the risk associated with high LDL, the “bad” cholesterol. Gene variations that caused high LDL levels were associated with increased risk of heart disease, as expected.
I’m guessing that this latest paper will lead to more research and a better understanding of the role lipoproteins play in the risk of heart disease. We need to find out, now, what’s actually lowering the risk of heart disease when we observe a high HDL, if in fact it’s not HDL itself.