High-density lipoproteins and cardiovascular disease: 2010 update

Khalid Alwaili, Zuheir Awan, Ali Alshahrani, Jacques Genest

Research output: Contribution to journalReview article

29 Citations (Scopus)

Abstract

High-density lipoprotein-cholesterol (HDL-C) is a continuous inverse cardiovascular risk factor. The mechanisms by which HDLs protect against atherosclerosis are multiple. The major effect is thought to be reverse cholesterol transport, the mechanism by which excess cellular cholesterol is returned to the liver for excretion in the bile. HDLs also have pleiotropic roles: they decrease inflammation, prevent low-density lipoprotein oxidation, vascular endothelial cell apoptosis and thrombosis, and improve vascular endothelial function. Recent studies suggest that nascent HDL particles are metabolized rapidly and that their components (Apo AI, cholesterol and phospholipids) are rapidly exchanged within lipoprotein classes. There are many causes of HDL-C deficiency. Using Mendelian randomization, several groups have concluded that many genetic forms of HDL deficiency do not increase cardiovascular risk. This raises the controversial issue of the causality of low HDL-C as a cardiovascular risk factor, rather than a marker of cardiovascular health. This is reflected in the importance of lifestyle in determining HDL-C levels. The treatment of low HDL-C remains controversial, in part because the only currently available effective medication, niacin, is relatively poorly tolerated and outcomes studies on cardiovascular disease prevention are still pending.

Original languageEnglish
Pages (from-to)413-423
Number of pages11
JournalExpert Review of Cardiovascular Therapy
Volume8
Issue number3
DOIs
Publication statusPublished - Mar 2010

Fingerprint

HDL Lipoproteins
HDL Cholesterol
Cardiovascular Diseases
Cholesterol
LDL Cholesterol
Pre-beta High-Density Lipoprotein
Niacin
Apolipoprotein A-I
Random Allocation
LDL Lipoproteins
Bile
Causality
Lipoproteins
Blood Vessels
Life Style
Phospholipids
Atherosclerosis
Thrombosis
Endothelial Cells
Outcome Assessment (Health Care)

Keywords

  • Atherosclerosis
  • Cardiovascular diseases
  • Cholesterol
  • High-density lipoproteins
  • Preventive cardiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

High-density lipoproteins and cardiovascular disease : 2010 update. / Alwaili, Khalid; Awan, Zuheir; Alshahrani, Ali; Genest, Jacques.

In: Expert Review of Cardiovascular Therapy, Vol. 8, No. 3, 03.2010, p. 413-423.

Research output: Contribution to journalReview article

Alwaili, Khalid ; Awan, Zuheir ; Alshahrani, Ali ; Genest, Jacques. / High-density lipoproteins and cardiovascular disease : 2010 update. In: Expert Review of Cardiovascular Therapy. 2010 ; Vol. 8, No. 3. pp. 413-423.
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