HDL Cholesterol and Cardiovascular Outcomes: What Is the Evidence?
- Melvyn RubenfireAffiliated withFrom the Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan24 Frank Lloyd Wright Dr. PO Box 322 Email author
- , Robert D. BrookAffiliated withFrom the Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan24 Frank Lloyd Wright Dr. PO Box 322
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The relationship between low concentrations of high density lipoprotein cholesterol (HDL-C) and heightened risk for cardiovascular (CV) disease has been known for decades. Despite the consistent inverse relationship among epidemiological studies, the linkage between a residual low HDL-C among patients treated with statins and excess cardiovascular risk is less clearly established. Encouraging results from trials using niacin over the past 40 years have not been validated among more recent trials in patients taking contemporary anti-atherosclerotic therapy. Emerging evidence suggests that certain subsets of HDL particles may be more protective and/or more closely associated with CV disease than others, which may impact therapeutic benefits. Ongoing clinical trials will clarify whether raising HDL-C per se directly translates into a reduction in hard CV events. Until those results are available, the clinician is left with only weak evidence to support whether or not to target treatment of HDL-C with pharmacological therapy.
KeywordsHigh density lipoprotein cholesterol Coronary heart disease Coronary disease risk HDL function HDL particles Cholesteryl ester transfer protein inhibitor AIM-HIGH Reverse cholesterol transport
- HDL Cholesterol and Cardiovascular Outcomes: What Is the Evidence?
Current Cardiology Reports
- Online Date
- February 2013
- Print ISSN
- Online ISSN
- Current Science Inc.
- Additional Links
- High density lipoprotein cholesterol
- Coronary heart disease
- Coronary disease risk
- HDL function
- HDL particles
- Cholesteryl ester transfer protein inhibitor
- Reverse cholesterol transport
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