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American Journal of Cardiovascular Drugs

, Volume 4, Issue 5, pp 299–314 | Cite as

Significance of High Density Lipoprotein-Cholesterol in Cardiovascular Risk Prevention

Recommendations of the HDL Forum
  • Juan F. Ascaso
  • Arturo Fernández-Cruz
  • Pedro González Santos
  • Antonio Hernández Mijares
  • Alipio Mangas Rojas
  • Jesus Millán
  • Luis Felipe Pallardo
  • Juan Pedro-Botet
  • Francisco Pérez-Jiménez
  • Gonzalo Pía
  • Xavier Pintó
  • Ignacio Plaza
  • Juan Rubiés-Prat
Review Article

Abstract

In the approach to lipid-related risk factors for cardiovascular diseases, serum high density lipoprotein-cholesterol (HDL-C) levels bear a particular significance as this lipoprotein is considered to be an antiatherogenic factor mainly, but not only, because of its influence and impact on reverse cholesterol transport. Hence the need and requirement to consider serum HDL-C levels for both primary and secondary prevention of cardiovascular disease. A particularly important aspect is the association of the ‘low HDL syndrome’ with the metabolic syndrome.

These factors force us to consider serum HDL-C level as a therapeutic target by itself, or even in association with low density lipoprotein-cholesterol (LDL-C) levels when the latter are increased. This review stresses the aspects connecting serum HDL-C levels and cardiovascular risk, and looks at the populations that should be considered amenable to therapeutic management because of low serum HDL-C levels.

We review therapeutic strategies, both pharmacological and nonpharmacological. The aim of this review is to present therapeutic management recommendations for correcting the proportion of cardiovascular risk that is attributable to changes in HDL-C. Serum HDL-C levels of >40 mg/dL must be a therapeutic target in primary and secondary prevention. This goal is particularly important in patients with low serum HDL-C levels and ischemic heart disease (IHD) or its equivalents, even if the therapeutic target for serum LDL-C levels (<100 mg/ dL) has been achieved. The first choice for this clinical condition is fibric acid derivates. The same therapeutic option should be considered in patients without IHD with low serum HDL-C levels and high cardiovascular risk (>20%), hypertriglyceridemia, type 2 diabetes mellitus, or metabolic syndrome.

Keywords

Fenofibrate Gemfibrozil Fibric Acid Derivative Cardiovasc Drug Ischemic Heart Disease Risk 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Adis Data Information BV 2004

Authors and Affiliations

  • Juan F. Ascaso
    • 1
  • Arturo Fernández-Cruz
    • 1
  • Pedro González Santos
    • 1
  • Antonio Hernández Mijares
    • 1
  • Alipio Mangas Rojas
    • 1
  • Jesus Millán
    • 1
    • 2
  • Luis Felipe Pallardo
    • 1
  • Juan Pedro-Botet
    • 1
  • Francisco Pérez-Jiménez
    • 1
  • Gonzalo Pía
    • 1
  • Xavier Pintó
    • 1
  • Ignacio Plaza
    • 1
  • Juan Rubiés-Prat
    • 1
  1. 1.HDL ForumMadridSpain
  2. 2.Servicio de Medicina Interna (III)Hospital General Universitario “Gregorio Marañón”MadridSpain

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