• Posted February 5, 2025

'Good' Cholesterol Could Be Bad For Glaucoma

The cholesterol that’s good for your heart health might be bad for your eye health, and vice versa, a new study says.

“Good” HDL cholesterol appears to increase risk of glaucoma in people older than 55, researchers reported Feb. 4 in the British Journal of Ophthalmology.

Conversely, “bad” LDL cholesterol might be associated with a lower risk of glaucoma, researchers report.

“HDL cholesterol has been regarded as the ‘good cholesterol’ for seven decades. However, this study demonstrates that high levels of HDL cholesterol are not consistently associated with a favorable prognostic outcome,” concluded the research team led by senior investigator Zhenzhen Liu, an associate professor with the Zhongshan Ophthalmic Center at Sun Yat-sen University in Guangdon, China.

LDL cholesterol contributes to plaque build-up in the arteries, which can eventually lead to heart disease, heart attack or stroke, according to the American Heart Association.

On the other hand, HDL cholesterol helps heart health by carrying some LDL cholesterol away from the arteries and back to the liver, where the LDL cholesterol is broken down and excreted, the AHA says.

Abnormally high levels of fats in the bloodstream have previously been linked to eye conditions like macular degeneration and diabetic retinopathy, researchers said in background notes.

But findings related to glaucoma have been inconsistent. Glaucoma causes fluid to build up within the eye, with the increasing pressure damaging the optic nerve.

For this study, researchers analyzed data on more than 400,000 participants in the long-range UK Biobank health research project. All participants had their blood fat levels tested and their health tracked for an average of 14 years.

Nearly 2% of the participants developed glaucoma during follow-up, and they tended to have higher HDL and lower LDL cholesterol, researchers said.

Analysis revealed that people with the highest level of “good” HDL cholesterol were 10% more likely to develop glaucoma than those with the lowest levels.

At the same time, those with the highest levels of “bad” LDL cholesterol were 8% less likely to develop glaucoma than people with the lowest levels.

The highest levels of another type of blood fat, triglycerides, also were associated with 14% lower risk of glaucoma, researchers found.

And as levels of each type of fat increased in the blood, they either raised or lowered glaucoma risk.

It’s not yet clear why the different types of cholesterol would affect glaucoma risk, researchers said.

However, these associations only persisted among people older than 55.

“These findings challenge existing paradigms about ‘good’ and ‘bad’ cholesterol in relation to eye health,” researchers concluded.

If follow-up studies validate these results, then doctors might need to reassess the use of cholesterol-lowering drugs in patients at risk for glaucoma, the researchers added.

More information

The American Academy of Ophthalmology has more on glaucoma.

SOURCE: British Journal of Ophthalmology, news release, Feb. 4, 2025