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Non-high-density lipoprotein cholesterol: why lower is better

Rahul Garg1, Chandrasekhar R Vasamreddy, Roger S Blumenthal

  • 1Johns Hopkins Ciccarone Preventive Cardiology Center, Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.

Preventive Cardiology
|July 22, 2005
PubMed

Insights

Lowering non-high-density lipoprotein cholesterol (non-HDL-C) offers clinical benefits, similar to low-density lipoprotein cholesterol (LDL-C). Statins effectively reduce both, with greater LDL-C reduction leading to greater non-HDL-C reduction.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Recent trials suggest lower low-density lipoprotein cholesterol (LDL-C) levels (<100 mg/dL) provide additional clinical benefit.
  • Non-high-density lipoprotein cholesterol (non-HDL-C) is a more comprehensive measure of atherogenic cholesterol particles than LDL-C.

Purpose of the Study:

  • To evaluate the principle that "lower is better" applies to non-HDL-C levels.
  • To assess the role of non-HDL-C as a secondary therapeutic target in patients with high triglycerides.
  • To examine the correlation between non-HDL-C, small dense LDL, and apolipoprotein B.

Main Methods:

  • Comparative trials of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins).
  • Analysis of lipid profiles, including LDL-C and non-HDL-C levels.
  • Correlation analysis with cardiovascular disease risk predictors.

Main Results:

  • Statins significantly reduce both LDL-C and non-HDL-C levels.
  • A direct relationship exists between the degree of LDL-C reduction and non-HDL-C reduction.
  • Non-HDL-C is strongly correlated with small dense LDL and apolipoprotein B.

Conclusions:

  • The "lower is better" principle is applicable to non-HDL-C reduction.
  • Statins are effective in lowering non-HDL-C, making it a valuable secondary therapeutic target.
  • Lowering non-HDL-C may offer additional cardiovascular risk reduction benefits.

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