Current Atherosclerosis Reports

, 16:429

HDL: To Treat or Not To Treat?

  • Angela Pirillo
  • Gianpaolo Tibolla
  • Giuseppe Danilo Norata
  • Alberico Luigi Catapano
Cardiovascular Disease and Stroke (P Perrone-Filardi and S. Agewall, Section Editors)

DOI: 10.1007/s11883-014-0429-x

Cite this article as:
Pirillo, A., Tibolla, G., Norata, G.D. et al. Curr Atheroscler Rep (2014) 16: 429. doi:10.1007/s11883-014-0429-x
Part of the following topical collections:
  1. Topical Collection on Cardiovascular Disease and Stroke

Abstract

Several studies have shown an inverse relationship between HDL cholesterol (HDL-C) levels and the risk of cardiovascular disease. Low HDL-C levels are commonly present in subjects with diabetes, metabolic syndrome, or obesity. These observations have suggested that increasing HDL concentrations might help in decreasing the cardiovascular disease risk. However, despite initial positive results, some recent data from clinical trials with HDL-raising therapies failed to confirm this hypothesis; in addition, data from Mendelian randomization analyses showed that nucleotide polymorphisms associated with increased HDL-C levels did not decrease the risk of myocardial infarction, further challenging the concept that higher HDL-C levels will automatically translate into lower cardiovascular disease risk. Differences in the quality and distribution of HDL particles might partly explain these findings, and in agreement with this hypothesis, some observations have suggested that HDL subpopulation levels may be better predictors of cardiovascular disease than simple HDL-C levels. Thus, it is expected that increased HDL-C levels may be beneficial when associated with an improvement in HDL function, suggesting that pharmacological approaches able to correct or increase HDL functions might produce more reliable clinical benefits.

Keywords

High-density lipoproteinResidual cardiovascular riskMendelian randomizationHDL-raising drugsHDL qualityHDL quantity

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Angela Pirillo
    • 1
    • 4
  • Gianpaolo Tibolla
    • 1
    • 4
  • Giuseppe Danilo Norata
    • 1
    • 2
    • 3
  • Alberico Luigi Catapano
    • 2
    • 4
  1. 1.Center for the Study of AtherosclerosisCinisello BalsamoItaly
  2. 2.Department of Pharmacological and Biomolecular SciencesUniversità degli Studi di MilanoMilanItaly
  3. 3.Centre for Diabetes, The Blizard Institute, Barts and The London School of Medicine & DentistryQueen Mary UniversityLondonUK
  4. 4.IRCCS MultimedicaMilanItaly