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Raising high-density lipoprotein cholesterol: where are we now?

C.M. Ballantyne*

Baylor College of Medicine, Houston, Texas, U.S.A.

* Christie M. Ballantyne, MD, Director, Center for Cardiovascular Disease Prevention, The Methodist DeBakey Heart Center, 6565 Fannin Street, MS A601, Suite A656B, Houston, TX 77030, U.S.A.

Abstract

Low levels of high-density lipoprotein cholesterol (HDL-C) are acknowledged as an independent risk factor for coronary heart disease. Evidence from trials of fibrate and statin treatment indicate that increasing levels of HDL-C or apolipoprotein (apo)A-I, or decreasing the apoB:apoA-I ratio produces significant benefit in reducing risk for coronary heart disease. These findings have indicated the potential need for defining therapeutic targets for HDL-C, apoA-I, or the apoB:apoA-I ratio. Clinical trials have recently shown differences among statins in terms of their ability to raise levels of HDL-C and apoA-I and to reduce the apoB:apoA-I ratio. Clinical trials are needed to test whether raising HDL-C or apoA-I and decreasing apoB:apoA-I ratio should be goals in lipid-modifying therapy and to assist in defining specific target levels.

Key Words: Apolipoprotein • coronary heart disease • high-density lipoprotein cholesterol • statins


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