High-density lipoprotein cholesterol raising: does it matter?

Abstract:

PURPOSE OF REVIEW:Cardiovascular disease (CVD) is the leading cause of morbidity and premature mortality in Europe and the United States, and is increasingly common in developing countries. High-density lipoprotein cholesterol (HDL-C) is an independent risk factor for CVD and is superior to low-density lipoprotein cholesterol (LDL-C) as a predictor of cardiovascular events. The residual risk conferred by low HDL-C in patients with a satisfactory LDL-C was recently highlighted by the European Atherosclerosis Society. Despite the lack of randomized controlled trials, it has been suggested that raising the level of HDL-C should be considered as a therapeutic strategy in high-risk patients because of the strong epidemiological evidence, compelling biological plausibility, and both experimental and clinical research supporting its cardioprotective effects. RECENT FINDINGS:Three recent large randomized clinical trials investigating the effect of HDL-C raising with niacin and dalcetrapib in statin-treated patients failed to demonstrate an improvement in cardiovascular outcomes. SUMMARY:There is evidence to support the view that HDL functionality and the mechanism by which a therapeutic agent raises HDL-C are more important than plasma HDL-C levels. Future therapeutic agents will be required to improve this functionality rather than simply raising the cholesterol cargo.

journal_name

Curr Opin Cardiol

authors

Schofield JD,France M,Ammori B,Liu Y,Soran H

doi

10.1097/HCO.0b013e328362210d

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

464-74

issue

4

eissn

0268-4705

issn

1531-7080

pii

00001573-201307000-00014

journal_volume

28

pub_type

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