High density lipoproteins (HDLs) and atherosclerosis; the unanswered questions

Philip Barter, John Kastelein, Alistair Nunn, Richard Hobbs, Jim Shepherd, Christie Ballantyne, Virgil Brown, Eric Bruckert, Rafael Carmena, Michael Davidson, Jean Davignon, Jean Charles Fruchart, Antonio Gotto, Jacques Genest, Wilhem Krone, Lawrence Leiter, Anders Olsson, Chris Packard, Rodolfo Paoletti, Yasushio SaitoAndrew Tonkin

Research output: Contribution to journalReview article

176 Scopus citations

Abstract

The concentration of high density lipoprotein-cholesterol (HDL-C) has been found consistently to be a powerful negative predictor of premature coronary heart disease (CHD) in human prospective population studies. There is also circumstantial evidence from human intervention studies and direct evidence from animal intervention studies that HDLs protect against the development of atherosclerosis. HDLs have several documented functions, although the precise mechanism by which they prevent atherosclerosis remains uncertain. Nor is it known whether the cardioprotective properties of HDL are specific to one or more of the many HDL subpopulations that comprise the HDL fraction in human plasma. Several lifestyle and pharmacological interventions have the capacity to raise the level of HDL-C, although it is not known whether all are equally protective. Indeed, despite the large body of information identifying HDLs as potential therapeutic targets for the prevention of atherosclerosis, there remain many unanswered questions that must be addressed as a matter of urgency before embarking wholesale on HDL-C-raising therapies as strategies to prevent CHD. This review summarises what is known and highlights what we still need to know.

Original languageEnglish (US)
Pages (from-to)195-211
Number of pages17
JournalAtherosclerosis
Volume168
Issue number2
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

Keywords

  • Antioxidant
  • Atherosclerosis
  • CAD
  • Endothelium
  • Fibrate
  • HDL
  • Inflammation
  • LDL
  • Mechanisms
  • Questions
  • Statin
  • Subgroup

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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