High-density lipoprotein quantity or quality for cardiovascular prevention?

Area of Science:

• Cardiovascular Medicine
• Biochemistry
• Lipidology

Background:

• Plasma high-density lipoprotein cholesterol (HDL-C) is inversely associated with cardiovascular risk.
• Therapies targeting HDL-C aim to be anti-atherogenic.
• HDL particles are heterogeneous, with subclasses possessing potentially different functional properties.

Purpose of the Study:

• To review the structural and functional heterogeneity of HDL particles.
• To assess the relationship between HDL subclasses and cardiovascular disease (CVD).
• To determine if HDL subclasses are superior predictors or therapeutic targets for CVD reduction compared to HDL-C.

Main Methods:

• Review of current scientific literature on HDL heterogeneity and CVD.
• Analysis of studies differentiating HDL subclasses by density, size, charge, and protein composition.
• Evaluation of evidence linking specific HDL subclasses to anti-atherogenic properties and CVD risk.

Main Results:

• HDL-C measurement is a limited snapshot of diverse HDL particle functions.
• Evidence suggests functional differences among HDL subclasses regarding anti-atherogenic properties.
• Certain HDL subclasses may be more informative than total HDL-C for risk assessment.

Conclusions:

• HDL heterogeneity is crucial for understanding its role in cardiovascular health.
• Specific HDL subclasses may serve as superior biomarkers for cardiovascular risk.
• Targeting distinct HDL subclasses could offer improved strategies for cardiovascular disease reduction.