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Related Experiment Videos

HDL in atherosclerosis: actor or bystander?

Bela F Asztalos1, Ernst J Schaefer

  • 1Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Center on Aging at Tufts University, and Division of Endocrinology, Metabolism, Diabetes, and Molecular Medicine, New England Medical Center, Boston, MA 02111, USA. bela.asztalos@tufts.edu

Atherosclerosis. Supplements
|April 26, 2003
PubMed
Summary

High-density lipoprotein (HDL) cholesterol may play an active role in preventing coronary heart disease (CHD), not just indicate risk. Research explores HDL

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Area of Science:

  • Cardiovascular Medicine
  • Lipid Metabolism
  • Pharmacology

Background:

  • Coronary heart disease (CHD) remains a leading cause of mortality globally.
  • Statins effectively reduce low-density lipoprotein (LDL) cholesterol, a primary CHD risk factor.
  • Low high-density lipoprotein (HDL) cholesterol is an independent CHD risk factor, yet no specific HDL goal exists.

Purpose of the Study:

  • To investigate the role of HDL cholesterol in CHD development.
  • To determine if specific HDL subspecies offer protection against CHD.
  • To clarify whether HDL is a CHD risk indicator or an active participant.

Main Methods:

  • Review of clinical trials (Helsinki Heart Study, VA-HILTI) using gemfibrozil to increase HDL.
  • Analysis of statin efficacy in lowering LDL and raising HDL cholesterol.

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  • Examination of HDL metabolism pathways, including cholesterol efflux and particle remodeling.

    • Main Results:

    • Gemfibrozil demonstrated significant reduction in coronary events and stroke in specific CHD patient groups.
    • Statins decrease total and LDL cholesterol and triglycerides, and also increase HDL concentrations.
    • HDL metabolism involves apolipoprotein A-I, ATP binding cassette transporter A-1, lecithin:cholesterol acyltransferase, CETP, hepatic lipase, and scavenger receptor B1.

    Conclusions:

    • HDL cholesterol appears to have an active role in cellular cholesterol efflux and may be protective against CHD.
    • Further research is needed to identify specific protective HDL subspecies.
    • Understanding HDL's role is crucial for developing new CHD prevention strategies.