期刊
JOURNAL OF CLINICAL LIPIDOLOGY
卷 4, 期 5, 页码 411-419出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacl.2010.08.004
关键词
apoAI; CETP; Cholesterol efflux; HDL; LXR; Reverse cholesterol transport
资金
- Merck
- Glaxo
- Abbott
- Pfizer
- ISIS
- Astra-Zeneca
The field of cardiovascular prevention has long anticipated the evolution of high-density lipoprotein (HDL) therapy from unproven metabolic tweaking to pillar of risk reduction on par with low-density lipoprotein control. However, the convincing epidemiologic data linking HDL cholesterol (HDL-C) and cardiovascular disease risk in an inverse correlation has not yet translated into clinical trial evidence supporting linearity between HDL-C increases and risk reduction, or identifying obvious goals of therapy. Although HDL-C-increasing lifestyle maneuvers and established HDL drugs such as niacin and fibrates are likely to protect the vasculature, the negative results obtained in trials of a cholesteryl ester transfer protein inhibitor remind us that HDL-C increases are not always beneficial. It is becoming clear that a functional HDL is a more desirable target than simply increasing HDL-C levels. The larger objective of improving HDL functionality (with or without HDL-C level changes) is bound to become the guiding principle for pharmaceutical research in this area. Several new compounds currently being tested bridge the classical aim of increasing HDL-C levels with the novel target of improving HDL function. (C) 2010 National Lipid Association. All rights reserved.
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