A new study published in the American Heart Association’s journal Arteriosclerosis, Thrombosis, and Vascular Biology has found that a high level of HDL or the so-called "good" cholesterol places a subgroup of patients at high risk for recurrent coronary events, such as chest pain, heart attack and death.

"It seems counterintuitive that increasing good cholesterol, which we’ve always thought of as protective, leads to negative consequences in some people," said the study’s lead author, James Corsetti, M.D., Ph.D. "We’ve confirmed that high HDL cholesterol is in fact associated with risk in a certain group of patients."

Researchers followed 767 non-diabetic patients who experienced at least one prior heart attack for approximately two years.

They found patients in the high-risk subgroup were characterized as having high levels of C-reactive protein (CRP), a well-known marker of inflammation, in addition to high HDL cholesterol.

Study authors believe genetics and environmental factors, particularly inflammation, influence whether high levels of HDL cholesterol are protective or if they increase cardiovascular risk in individual patients.

Eating a healthy, low-fat diet, weight management and increased physical activity are all encouraged to help keep cholesterol levels in check.

Nutritional supplements containing policosanol and krill oil as well as cinnamon, pomegranate and artichoke may also help naturally lower cholesterol.