The Importance of Recognizing and Treating Low Levels of High-Density Lipoprotein Cholesterol: A New Era in Atherosclerosis Management Article

PMID: 19122582 Web of Science: 000262262800006

Cited authors

  • Cardenas, Gustavo A.; Lavie, Carl J.; Cardenas, Vanessa; Milani, Richard V.; McCullough, Peter A.


  • Low levels of high-density lipoprotein cholesterol (HDL-C) represent a major cardiovascular risk factor, with a stronger relationship to coronary heart disease than that seen with elevated levels of low-density lipoprotein cholesterol (LDL-C). HDL-C has important antiatherogenic effects, including reverse cholesterol transport, inhibition of LDL-C oxidation, and antiplatelet and anti-inflammatory actions. Patients with low HDL-C are also at an amplifled risk of coronary heart disease due to the common coexistence of other risk factors, including excess adiposity, metabolic syndrome, type 2 diabetes mellitus, hypertriglyceridemia, and the atherogenic dyslipidemia characterized by small dense LDL-C. First-line therapy of low HDL-C generally consists of nonpharmacologic measures such as improved fitness and weight loss. Current pharmaceutical options include statins, fibrates, and nicotinic acid. A host of novel approaches involving HDL-C and reverse cholesterol transport hold the promise of fundamentally changing the natural history of atherosclerosis, the most common and important chronic disease in humans.

Publication date

  • 2008

Published in

International Standard Serial Number (ISSN)

  • 1530-6550

Start page

  • 239

End page

  • 258


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