High-density lipoprotein therapeutics and cardiovascular prevention

Sergio Fazio, MacRae F. Linton

Research output: Contribution to journalReview articlepeer-review

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 2010
Externally publishedYes

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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