HDL values and cardiovascular event rates

Connection between HDL values and Cardiovascular event rates under scrutiny
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HDL-raising: A good hypothesis gone bad

By: BRUCE JANCIN, Cardiology News Digital Network SNOWMASS, COLO. – The once highly attractive notion that boosting HDL cholesterol levels will reduce cardiovascular event rates is now dead, or more generously, it remains unsupported by evidence despite expenditure of billions of dollars on negative clinical trials. "An iconic concept of HDL has not borne good fruit. It really isn’t what we don’t know that hurts us so much as the things that we think are true but just ain’t so – and that’s the story of HDL," Dr. Robert A. Vogel said at the annual cardiovascular conference at Snowmass sponsored by the American College of Cardiology. Indeed, it now appears that the relationship between HDL and atherosclerosis is far more complicated than lipidologists thought. Evidence now suggests that HDL mass may not be as important as HDL function, which can switch between being anti- and pro-atherogenic in a matter of hours. And HDL may not even be playing an active role in cardiovascular risk; a low HDL may be associated with an increase in cardiovascular events simply because it is a marker for other cardiovascular risk factors, such as obesity, smoking, and insulin resistance.