Multiple facets of HDLs as modifiable risk factors in stroke-the good, the bad, and the ugly

Area of Science:

• Cardiovascular Science
• Neuroscience
• Lipid Metabolism

Background:

• High-density lipoprotein (HDL) is studied for its role in cardiovascular diseases and atherogenesis.
• Plasma HDL cholesterol (HDL-C) levels show an inverse relationship with stroke risk, but this association is complex.
• HDL particle heterogeneity and functionality are critical but understudied aspects in stroke risk prediction.

Purpose of the Study:

• To review the current literature on the multifaceted relationship between HDL and stroke.
• To highlight the importance of HDL functionality beyond cholesterol levels in stroke pathophysiology.
• To identify gaps in research regarding HDL heterogeneity and its impact on stroke.

Main Methods:

• Literature review of contemporary studies on HDL and stroke.
• Analysis of factors contributing to HDL heterogeneity (e.g., subspecies, lipid/protein content).
• Examination of HDL's functional properties (e.g., antioxidant, anti-inflammatory) in stroke prevention.

Main Results:

• HDL-C levels alone are insufficient for predicting stroke risk.
• HDL particle heterogeneity significantly influences its atheroprotective and potentially stroke-protective functions.
• Antioxidant and anti-inflammatory properties of HDL may be crucial for preventing atherosclerosis-related stroke.

Conclusions:

• Understanding HDL's diverse functionalities is essential for a comprehensive assessment of stroke risk.
• Future research should focus on HDL subspecies and functional assays to refine stroke risk prediction.
• Targeting HDL functionality may offer novel therapeutic strategies for stroke prevention.