Abstract
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 amplified 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.
MeSH terms
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Apolipoprotein A-I / therapeutic use
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Atherosclerosis / blood
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Atherosclerosis / etiology
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Atherosclerosis / prevention & control*
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Cardiovascular Diseases / blood
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Cardiovascular Diseases / etiology
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Cardiovascular Diseases / prevention & control*
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Cholesterol Ester Transfer Proteins / antagonists & inhibitors
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Cholesterol, HDL / blood*
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Clofibric Acid / therapeutic use
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Combined Modality Therapy
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Diet
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Down-Regulation
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Drug Therapy, Combination
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Drugs, Investigational / therapeutic use
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Dyslipidemias / blood
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Dyslipidemias / complications
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Dyslipidemias / therapy*
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Exercise
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
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Hypolipidemic Agents / adverse effects
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Hypolipidemic Agents / therapeutic use*
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Niacin / therapeutic use
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Peptides / therapeutic use
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Receptors, Prostaglandin / antagonists & inhibitors
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Risk Reduction Behavior*
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Treatment Outcome
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Weight Loss
Substances
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Apolipoprotein A-I
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CETP protein, human
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Cholesterol Ester Transfer Proteins
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Cholesterol, HDL
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Drugs, Investigational
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Hypolipidemic Agents
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Peptides
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Receptors, Prostaglandin
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prostanoid D receptor 1, human
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Niacin
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Clofibric Acid