High-density lipoprotein therapeutics and cardiovascular prevention

Sergio Fazio, MacRae F. Linton

    Research output: Contribution to journalReview article

    20 Scopus citations

    Abstract

    The field of cardiovascular prevention has long anticipated the evolution of high-density lipoprotein (HDL) therapy from unproven metabolic tweaking to pillar of risk reduction on par with low-density lipoprotein control. However, the convincing epidemiologic data linking HDL cholesterol (HDL-C) and cardiovascular disease risk in an inverse correlation has not yet translated into clinical trial evidence supporting linearity between HDL-C increases and risk reduction, or identifying obvious goals of therapy. Although HDL-C-increasing lifestyle maneuvers and established HDL drugs such as niacin and fibrates are likely to protect the vasculature, the negative results obtained in trials of a cholesteryl ester transfer protein inhibitor remind us that HDL-C increases are not always beneficial. It is becoming clear that a functional HDL is a more desirable target than simply increasing HDL-C levels. The larger objective of improving HDL functionality (with or without HDL-C level changes) is bound to become the guiding principle for pharmaceutical research in this area. Several new compounds currently being tested bridge the classical aim of increasing HDL-C levels with the novel target of improving HDL function.

    Original languageEnglish (US)
    Pages (from-to)411-419
    Number of pages9
    JournalJournal of clinical lipidology
    Volume4
    Issue number5
    DOIs
    StatePublished - Sep 1 2010

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    Keywords

    • CETP
    • Cholesterol efflux
    • HDL
    • LXR
    • Reverse cholesterol transport
    • apoAI

    ASJC Scopus subject areas

    • Internal Medicine
    • Endocrinology, Diabetes and Metabolism
    • Nutrition and Dietetics
    • Cardiology and Cardiovascular Medicine

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