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Related Experiment Video

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HDL re-examined.

G Kees Hovingh1, Daniel J Rader, Robert A Hegele

  • 1aDepartment of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands bDepartment of Medicine and Genetics, Institute for Translational Medicine and Therapeutics, and Cardiovascular Institute, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA cDepartment of Medicine and Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Current Opinion in Lipidology
|February 19, 2015
PubMed
Summary
This summary is machine-generated.

High-density lipoprotein cholesterol (HDL-C) levels predict cardiovascular disease (CVD) risk, but its causal role is debated. Research now focuses on HDL functionality rather than just HDL-C levels for CVD risk assessment.

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Area of Science:

  • Cardiovascular Disease Research
  • Lipid Metabolism
  • Atherosclerosis

Background:

  • Plasma high-density lipoprotein cholesterol (HDL-C) levels are inversely associated with cardiovascular disease (CVD) risk.
  • HDL-C is widely used in CVD risk estimation models.
  • The causal role of HDL in CVD is increasingly questioned by recent studies.

Purpose of the Study:

  • To review current evidence on HDL-C and associated parameters in CVD risk.
  • To explore the shift in focus from HDL-C levels to HDL functionality.
  • To assess the implications for CVD risk prediction and therapeutic targeting.

Main Methods:

  • Review of population studies and clinical trials.
  • Analysis of genetic studies.
  • Evaluation of HDL functionality markers, such as HDL efflux capacity.

Main Results:

  • Inverse association between HDL-C levels and CVD risk confirmed.
  • Genetic and clinical trial data challenge the causal role of HDL-C in atherosclerosis.
  • HDL efflux capacity shows potential as an independent predictor of CVD events.
  • Numerous clinical trials investigating HDL-C-raising agents are ongoing.

Conclusions:

  • The predictive value of HDL-C for CVD events is established, but its causal role is debated.
  • A paradigm shift towards evaluating 'HDL functionality' is evident.
  • Further prospective studies are needed to confirm if optimizing HDL functionality reduces CVD risk.