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Published on: October 12, 2017
The role of high-density lipoprotein cholesterol in atherothrombosis
Brian G Choi1, Gemma Vilahur, Juan F Viles-Gonzalez
1Cardiovascular Biology Research Laboratory, Zena and Michael A. Wiener Cardiovascular Institute, Box 1030, Mount Sinai School of Medicine, One East 100 th Street, New York, NY 10029, USA.
Insights
Coronary heart disease (CHD) is a leading cause of death. While low high-density lipoprotein (HDL) is a risk factor, therapies to raise HDL for CHD prevention are still under development.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality globally.
- Low high-density lipoprotein (HDL) cholesterol levels are linked to increased CHD risk.
- Current therapeutic strategies for CHD have limitations, and HDL-raising therapies are not yet standard.
Purpose of the Study:
- To review the current understanding of high-density lipoprotein (HDL) in atherosclerosis.
- To discuss the challenges and potential of raising HDL as a therapeutic strategy for coronary heart disease (CHD).
- To explore emerging pharmacologic approaches for potent HDL elevation.
Main Methods:
- Review of existing literature on HDL, atherosclerosis, and lipid-lowering therapies.
- Analysis of the effects of current drugs on HDL and other lipids.
- Discussion of basic science findings on HDL's beneficial roles.
Main Results:
- Available HDL-raising drugs also impact other lipids, complicating assessment of HDL's independent effect.
- Basic science research indicates multiple protective functions of HDL.
- Development of novel drugs with potent HDL-elevating capabilities is ongoing.
Conclusions:
- Despite challenges, raising HDL holds promise for managing atherosclerotic diseases.
- Future pharmacologic advancements may establish HDL elevation as a standard treatment for CHD.
- Further research is needed to fully elucidate and leverage HDL's therapeutic potential in cardiovascular disease.
Abstract:
Despite considerable progress in the development of new therapies to control atherosclerosis and its complications, coronary heart disease (CHD) remains the number one cause of death in the Western world. While low high-density lipoprotein (HDL) has been associated with increased risk for CHD, raising HDL to reduce risk of disease has yet to be accepted as a standard therapeutic strategy. Currently available drugs that raise HDL (e.g., nicotinic acid, fibric acid derivatives, peroxisome proliferator-activated receptor agonists, and statins) also affect low-density lipoprotein (LDL) and other lipid constituents, making independent interpretation of their HDL-raising effect difficult to tease apart. Nevertheless, basic science studies suggest that HDL has multiple beneficial effects, and current efforts to develop new pharmacologic products with potent HDL-elevating effects may herald a day when HDL elevation becomes part of standard management of atherosclerotic diseases.
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