Effects of established hypolipidemic drugs on HDL concentration, subclass distribution, and function

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Monica Gomaraschi1, Maria Pia Adorni, Maciej Banach

  • 1Center E. Grossi Paoletti, Department of Pharmacological and Biomolecular Sciences, University of Milano, Via Balzaretti 9, 20133, Milan, Italy, monica.gomaraschi@unimi.it.

Handbook of Experimental Pharmacology
|December 20, 2014
PubMed

Insights

Increasing high-density lipoprotein cholesterol (HDL-C) may protect against cardiovascular disease. This review examines how statins, fibrates, and niacin affect HDL-C levels and function.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Lipid Metabolism

Background:

  • An inverse relationship exists between high-density lipoprotein cholesterol (HDL-C) and cardiovascular disease (CVD) risk.
  • Increasing HDL-C is hypothesized to be protective against cardiovascular events.
  • Current lipid-lowering therapies have limited, non-specific effects on HDL-C.

Purpose of the Study:

  • To review the impact of established hypolipidemic drugs on HDL-C.
  • To examine effects on HDL subclass distribution and function.
  • To assess HDL functions like cholesterol efflux, endothelial protection, and antioxidant properties.

Main Methods:

  • Review of established hypolipidemic drugs: statins, fibrates, and niacin.
  • Analysis of their effects on plasma HDL-C concentrations.
  • Evaluation of impacts on HDL subclass distribution and functional assays.

Main Results:

  • Statins yield modest HDL-C increases (2-10%).
  • Fibrates offer moderate HDL-C elevation (5-15%).
  • Niacin is most potent (up to 30%) but has side effects.

Conclusions:

  • Established hypolipidemic drugs have varying effects on HDL-C levels.
  • Further research is needed to understand their impact on HDL function.
  • Optimizing HDL-C and function remains a target for CVD prevention.

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