Document Detail


Emerging strategies and agents to lower cardiovascular risk by increasing high density lipoprotein cholesterol levels.
MedLine Citation:
PMID:  19149567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
For decades, the focus of therapy to mitigate cardiovascular risk has been to lower low density lipoprotein cholesterol (LDL-C), so called "bad cholesterol". Widespread use of statins has resulted in a large body of clinical experience, which indicates that lower LDL-C levels do indeed correlate with decreased risk of cardiovascular and coronary artery diseases (CVD and CAD). Given these findings, recommended targets for LDL-C levels are continually being revised lower. Interestingly, however, even at low LDL-C levels there remains a substantial residual risk of CVD and CAD, particularly in patients with additional contributing factors. Recent post-hoc analyses of several large lipid modulation trials specifically assessing high density lipoprotein cholesterol (HDL-C) have revealed that increased HDL-C levels confer additional benefit against risk of CVD and CAD, even when LDL-C levels are already low. Human clinical outcomes trials that specifically target increasing HDL-C have not yet been conducted. However, the strong epidemiological inverse correlation between HDL-C and CVD risk remains. Discovery efforts aimed at increasing circulating levels of HDL-C have increased dramatically in recent years. This review will cover recent efforts and agents being developed such as cholesterol ester transfer protein inhibitors and nicotinic acid receptor agonists among other potential strategies.
Authors:
Scott Greenfeder
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current medicinal chemistry     Volume:  16     ISSN:  0929-8673     ISO Abbreviation:  Curr. Med. Chem.     Publication Date:  2009  
Date Detail:
Created Date:  2009-01-19     Completed Date:  2009-03-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440157     Medline TA:  Curr Med Chem     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  144-56     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular and Metabolic Diseases, Schering-Plough Research Institute, USA. scott.greenfeder@spcorp.com
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MeSH Terms
Descriptor/Qualifier:
Anticholesteremic Agents / therapeutic use
Antilipemic Agents / therapeutic use
Cardiovascular Diseases / drug therapy*
Cholesterol Ester Transfer Proteins / antagonists & inhibitors
Cholesterol, HDL / blood,  drug effects,  metabolism*
Cholesterol, LDL / blood,  metabolism
Coronary Artery Disease / drug therapy,  etiology,  prevention & control
Humans
Receptors, Cytoplasmic and Nuclear / agonists
Receptors, G-Protein-Coupled / agonists
Risk Factors
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Antilipemic Agents; 0/Cholesterol Ester Transfer Proteins; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Receptors, Cytoplasmic and Nuclear; 0/Receptors, G-Protein-Coupled

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