Dr. Sinatra goes on to explain that even HDL has been shown to have varying degrees of quality and some can actually be categorized as “bad.” The HDL of people with chronic diseases is very different than the HDL of healthy folks; normal “good” HDL reduces inflammation while dysfunctional, or “bad” HDL does not. Sinatra urges readers to ask their physicians to find out what kind of HDL they have.

Because of their ability to reduce inflammation (not cholesterol), Dr. Sinatra does prescribe statin medications, on occasion. However, he limits his prescriptions almost exclusively to high risk, middle-aged men, less than 69 years of age, who have already experienced a first heart attack, coronary intervention (e.g., bypass, stent, angioplasty) or coronary artery disease. He does not prescribe statins for the elderly (70 and above) or generally for women, except in rare circumstances. In place of medications, Sinatra prefers to lower inflammation, and therefore the risk of heart disease, with natural supplements, an improved diet, and lifestyle changes which include managing stress. This prescription for reducing inflammation has only one side effect: better heart health.