The Role of High-Density Lipoprotein Cholesterol in 2022

Area of Science:

• Cardiovascular Science
• Lipid Metabolism
• Molecular Medicine

Background:

• High-density lipoproteins (HDL) transport plasma lipids and are key in cardiovascular (CV) risk assessment.
• HDL-associated cholesterol (HDL-C) evaluation is a standard CV risk metric.
• Mechanisms of HDL's arterial benefits are extensively studied.

Purpose of the Study:

• To review novel findings on HDL's role in CV risk determination.
• To investigate the mechanisms underlying HDL's impact on cardiovascular health.
• To explore emerging diagnostic and therapeutic strategies related to HDL.

Main Methods:

• Review of recent scientific literature on HDL function and cardiovascular risk.
• Analysis of clinical trial data regarding HDL-C modulation.
• Examination of HDL's anti-inflammatory, anti-oxidative, and anti-infectious properties.

Main Results:

• HDL's functional capacity, rather than solely elevated levels, correlates with CV protection.
• A U-shaped relationship exists between HDL-C levels and coronary risk.
• High HDL-C may be linked to non-vascular conditions like age-related macular disease.
• HDL's pleiotropic effects (anti-inflammatory, anti-oxidative) suggest new therapeutic avenues.
• Clinical trials to increase HDL-C pharmacologically have yielded inconclusive results.
• HDL-targeted therapies show promise in stent occlusion prevention and heart failure treatment.

Conclusions:

• HDL's functional capacity is crucial for cardiovascular protection.
• The relationship between HDL-C levels and CV risk is complex, with potential risks at very high levels.
• Further research and targeted clinical studies are needed to optimize HDL-based diagnostics and therapeutics.