Salmon is rich in omega-3 fatty acids, which are healthy fats that can help reduce blood pressure. Eating salmon can improve your "good" HDL cholesterol, but it won't lower your "bad" LDL cholesterol. HDL cholesterol helps sweep cholesterol off your artery walls, preventing dangerous plaque from forming. The American Heart Association recommends eating fatty fish like salmon at least twice per week for heart-healthy benefits. Other fish that contain omega-3s, such as mackerel, tuna and sardines, can also help.
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While this belief is still thought to be almost always true, in recent years a fly has been found in the ointment. Drug companies have spent billions of dollars developing drugs that increase HDL cholesterol levels. However, to the dismay of all, these drugs have failed to reduce cardiac risk—despite the fact that they make HDL levels go up. Development of at least two of these drugs has now been halted. (More on this below.) So the HDL story is more complex than scientists originally had hoped.
While it has been proven via multiple studies that elevated levels of low-density lipoprotein (LDL) contribute to the development of atherosclerosis, high-density lipoprotein (HDL) is widely thought to have atheroprotective effects. Results from multiple epidemiologic studies of healthy populations (most importantly, from the Framingham Heart Study) have given rise to the idea that high HDL levels protect against coronary heart disease (CHD). Patients with known CHD have been found to have lower levels of HDL. [1, 2]
About 80 percent of calories in nuts come from fat, but it's healthy unsaturated fat, not the artery-clogging kind. Nuts also are high in plant sterols, substances that block the absorption of cholesterol. Given these advantages, nuts are a natural for a heart-healthy diet. About an ounce and a half to two ounces a day should do it. Walnuts, almonds, hazelnuts, pecans and pistachios all confer benefits. So do peanuts, although they're technically a legume and not a nut.
Niacin is a B vitamin that your body uses to turn food into energy. It also helps keep your digestive system, nervous system, skin, hair and eyes healthy. Most people get enough niacin or B3 from their diets, but niacin is often taken in prescription-strength doses to treat low HDL levels. Niacin supplementation can can raise HDL cholesterol by more than 30 percent. (7)
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Plant stanols and sterols (such as beta-sitosterol and sitostanol) are naturally-occurring substances found in certain plants. Stanols are also found as dietary supplements or are added to margarine, orange juice, and dressings. Research suggests that plant stanols and sterols may help to lower cholesterol. They are similar in structure to cholesterol and may help block the absorption of cholesterol from the intestines.
With apologies to the American Heart Association, which discourages doctors from telling their patients about the advantages of alcohol: one or two drinks per day can significantly increase HDL levels. More than one or two drinks per day, one hastens to add, can lead to substantial health problems including heart failure. And unfortunately, there are many people who are simply incapable of limiting their alcohol intake to one or two drinks per day. Here's more on alcohol and the heart.
If you smoke, it’s time to pack it in. According to the American Heart Association, smoking reduces your HDL cholesterol levels, while increasing your risk of heart disease, high blood pressure and diabetes. If you’re a smoker, you need to quit. Once you stop smoking, you can significantly improve your HDL cholesterol level very quickly and start protecting your heart. And if you’re a non-smoker, you need to avoid exposure to second-hand smoke to prevent your health from going up in smoke.