Artificially Raised HDL Ineffective

Robert W. Griffith, MD

We know by now that elevated high-density lipoprotein (HDL) cholesterol levels are a good thing - along with a lower LDL-cholesterol, a higher HDL-cholesterol protects against cardiovascular disease and events such as heart attack and stroke. This was supported by a report from Italy showing that an abnormally large HDL-cholesterol molecule helps reduce the thickness of atheromatous plaques - the signal evidence of atherosclerosis.

There are two new reports of attempts to give HDL-cholesterol a quick boost, to see if this is a possible approach to 'melting' atheromatous plaques. In the first, reported in JAMA , infusions of HDL-cholesterol were given weekly to patients with recent acute coronary artery problems. After 6 weeks, there was no advantage of the HDL-cholesterol infusions over placebo infusions. However, the study may have been too short to demonstrate al possible benefits.

In the second instance, reports in the New England Journal of Medicine describe disappointing results with an investigational drug, torcetrapib. This drug was designed to raise HDL-cholesterol and reduce atherosclerosis, and it showed early promise in animal models. However, when used together with a statin in patients with raised cholesterol levels, there was an increase in early signs of atherosclerosis in the patients given torcetrapib.

Two setbacks - but the aim of increasing your HDL by appropriate lifestyle modifications is still a good one; it's just that we'll have to look for another approach to finding helpful medications.

Source
HealthandAge Blog

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