HDL cholesterol: physiology, pathophysiology, and management.
Numerous epidemiological studies have identified high-density lipoprotein cholesterol (HDL) to be an independent risk factor for coronary heart disease (CHD). HDL is an emerging therapeutic target that could rival the impact of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) on LDL and CHD risk reduction. HDL metabolism, HDL kinetics, the concentration of various HDL subclasses, and other genetic factors affecting HDL functionality may all contribute to the anti-atherogenic properties of HDL; thus, standard plasma measurement may not capture the full range of HDL effects. Algorithms have been suggested to treat low HDL levels in subgroups of patients; however, no formal HDL target goals or treatment guidelines have been implemented as there is a lack of strong clinical evidence to support effective pharmacologic therapy for primary risk reduction. Available therapies have a modest impact on serum HDL levels; however, emerging therapies could have a more significant influence.
Link
Jeffrey J
JJ
Department of Internal Medicine, Parkland Memorial Hospital affiliated with the University of Texas, Southwestern Medical Center, Dallas, Texas 75390-9047, USA.
Rohatgi
Anand
A
de Lemos
James A
JA
D000818:Animals; D008076:Cholesterol, HDL / Q000097:blood* / Q000187:drug effects / Q000378:metabolism; D003327:Coronary Disease / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology* / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy*; D008019:Life Style; D015227:Lipid Peroxidation; D018384:Oxidative Stress; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D014661:Vasoconstriction; D014664:Vasodilation
D008076:Cholesterol, HDL