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Therapeutic manipulation of HDL fails to benefit adults with heart disease

BMJ 2012; 345 doi: (Published 13 November 2012) Cite this as: BMJ 2012;345:e7643

Re: Therapeutic manipulation of HDL fails to benefit adults with heart disease

Many still rely on plasma cholesterol level to assess cardiac risk in such patients in spite of numerous studies indicating that triglycerides are another important risk factor to be considered.

A few studies that emphasized a fall in plasma cholesterol level which was associated with a reduction of coronary artery disease did not take the triglyceride effect into consideration. This led to overestimation of cholesterol reduction as the major concern in patients with coronary artery disease and resulted in giving more importance to hypocholesterolemic agents.

However, the focus is now shifted to other therapeutic methods such as raising HDL cholesterol levels through administration of CETP inhibitors. The rationale behind such treatments is based on the supposition that increased HDL will benefit CAD patients. The fact remains that HDL can be dysfunctional when reactive oxygen species can damage its overall structural composition and function. This is proved by the findings of studies related to CETP inhibitors which failed to elicit a positive response. These findings seem to suggest that it is more important to restore HDL cholesterol functionality than merely increasing HDL cholesterol levels, prompting more studies to evaluate the dynamics of lipoprotein metabolism in health and disease in general.

D.S.Sheriff et al.Triglyceride effect’ on the dynamics of plasma lipoproteins and its possible link to atherogenesis.Lib J Med 20122012, 7: 18909 -

Competing interests: No competing interests
21 November 2012
dhastagir s sheriff
Faculty of Medicine, Benghazi University
Benghazi, Libya
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