title: HDL-C levels and cardiovascular disease: more is not always better!
abstract: HMG-CoA reductase inhibitors have consistently demonstrated a relative risk reduction of death and myocardial infarction ranging between 29 and 35%. Nevertheless, in spite of significant improvement in prevention, cardiovascular disease remains the main cause of morbidity and mortality in industrialized countries. This significant residual risk observed in approximately 70% of patients under optimal anti-atherosclerotic therapies, warrants the exploration and development of alternative cardiovascular drugs. Specifically, HDL-C levels have been inversely correlated with the incidence of cardiovascular disease and an estimated 1 mg/dl higher HDL-C is associated with a 2% lower risk for men and a 3% lower risk for women. However, HDL-C-C pharmacological induced increases presented contradicting results regarding atherosclerotic development and in some cases increased cardiovascular mortality. In this review, we will focus on the structure and metabolism of HDL-C and patents related to HDL-C levels and cardiovascular disease along with the possible role of HDL-C increasing therapies in the future primary and secondary prevention of cardiovascular disease.
authors.affiliation: Instituto de Investigaciones Cardiológicas Alberto C. Taquini (UBA-CONICET), Buenos Aires, Argentina. santimcl@gmail.com
authors.forename: Santiago
authors.initials: S
authors.lastname: Mc Loughlin
authors.forename: Gastón A
authors.initials: GA
authors.lastname: Rodríguez-Granillo
mesh_terms: D064286:ATP Binding Cassette Transporter 1; D018528:ATP-Binding Cassette Transporters / Q000096:biosynthesis / Q000187:drug effects; D000818:Animals; D000924:Anticholesteremic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D016632:Apolipoprotein A-I / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000378:metabolism*; D053480:Cholesterol Ester Transfer Proteins / Q000037:antagonists & inhibitors; D008076:Cholesterol, HDL / Q000187:drug effects* / Q000378:metabolism* / Q000627:therapeutic use; D015438:Health Behavior; D006801:Humans; D008954:Models, Biological; D047492:Peroxisome Proliferator-Activated Receptors / Q000819:agonists; D011994:Recombinant Proteins / Q000627:therapeutic use; D040242:Risk Reduction Behavior
chemical_list: D064286:ATP Binding Cassette Transporter 1; D018528:ATP-Binding Cassette Transporters; D000924:Anticholesteremic Agents; D016632:Apolipoprotein A-I; C506642:CETP protein, human; D053480:Cholesterol Ester Transfer Proteins; D008076:Cholesterol, HDL; D047492:Peroxisome Proliferator-Activated Receptors; D011994:Recombinant Proteins