Low high-density lipoprotein cholesterol disorders and cardiovascular risk: contribution of associated low-density lipoprotein subclass abnormalities.
OBJECTIVE
Discuss the contribution of low-density lipoprotein subclass abnormalities to cardiovascular risk among individuals with low high-density lipoprotein cholesterol levels.


RESULTS
Low high-density lipoprotein cholesterol levels are commonly encountered among patients with early onset cardiovascular disease. Most often, a low high-density lipoprotein cholesterol level is not an isolated abnormality, but it is usually associated with a number of other lipoprotein abnormalities. Data from the Framingham Offspring Study demonstrate that among subjects with high-density lipoprotein cholesterol, 1.0 mmol/L (39 mg/dL), low-density lipoprotein particle numbers were considerably higher than indicated by the level of low-density lipoprotein cholesterol because these subjects had excess numbers of small cholesterol-depleted low-density lipoprotein particles. Elevated numbers of low-density lipoprotein particles identify individuals at highest risk for atherosclerotic vascular disease and cardiovascular events.


CONCLUSIONS
As high levels of low-density lipoprotein particles are a robust predictor of cardiovascular events, strategies targeted at raising low levels of high-density lipoprotein cholesterol must account for low-density lipoprotein particle interactions.
Rosenson
Robert S
RS
Preventive Cardiology Center, Northwestern University, The Feinberg School of Medicine, Galter Pavilion 11-120, 201 East Huron Street, Chicago, IL 60611, USA. r-rosenson@northwestern.edu
D050197:Atherosclerosis / Q000097:blood / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000097:blood* / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D015248:Gemfibrozil / Q000627:therapeutic use; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008077:Lipoproteins, LDL / Q000097:blood; D008148:Lovastatin / Q000627:therapeutic use; D012307:Risk Factors; D019821:Simvastatin / Q000627:therapeutic use
D008076:Cholesterol, HDL; D000960:Hypolipidemic Agents; D008077:Lipoproteins, LDL; D002784:Cholesterol; D008148:Lovastatin; D019821:Simvastatin; D015248:Gemfibrozil