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Progression and regression of atherosclerosis, what roles for LDL-cholesterol and HDL-cholesterol: a perspective

J D Barth1, A C Arntzenius

  • 1Department of Cardiology, St. Radboud University Hospital, Nijmegen, The Netherlands.

European Heart Journal
|August 1, 1991
PubMed

Insights

High total cholesterol (and LDL) promotes atherosclerosis progression, while low HDL cholesterol predicts coronary heart disease. New research suggests HDL cholesterol may drive regression of coronary atherosclerosis.

Area of Science:

  • Cardiology
  • Biochemistry
  • Epidemiology

Background:

  • Observational and intervention studies link total and LDL cholesterol to atherosclerosis progression.
  • Low HDL cholesterol is a known predictor of coronary heart disease (CHD).

Purpose of the Study:

  • To review recent angiographic studies providing new insights into the roles of total/LDL and HDL cholesterol in coronary atherosclerosis.
  • To differentiate the impact of cholesterol types on atherosclerosis progression versus regression.

Main Methods:

  • Review of recent studies utilizing repeat angiographic examinations.
  • Analysis of epidemiological data from observational and intervention studies.

Main Results:

  • Total (and LDL) cholesterol correlates positively with the progression of atherosclerosis.
  • HDL cholesterol is strongly associated with the regression of coronary atherosclerosis.
  • A theory emerges: progression correlates with total/LDL cholesterol, regression with HDL cholesterol.

Conclusions:

  • Cholesterol plays distinct roles in atherosclerosis: total/LDL cholesterol in progression and HDL cholesterol in regression.
  • This understanding has significant implications for primary and secondary preventive strategies against cardiovascular disease.

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