| High-density lipoprotein as a therapeutic target: clinical evidence and treatment strategies. | |
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MedLine Citation:
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PMID: 16291015 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The clinical importance of low serum levels of high-density lipoprotein (HDL) cholesterol is often under-recognized and underappreciated as a risk factor for premature atherosclerosis as well as for cardiovascular morbidity and mortality. Low serum levels of HDL are frequently encountered, especially in patients who are obese or have the metabolic syndrome. In prospective epidemiologic studies, every 1-mg/dL increase in HDL is associated with a 2% to 3% decrease in coronary artery disease risk, independent of low-density lipoprotein (LDL) cholesterol and triglyceride (TG) levels. The primary mechanism for this protective effect is believed to be reverse cholesterol transport, but several other anti-inflammatory, antithrombotic, and antiproliferative functions for HDL have also been identified. In recognition of these antiatherogenic effects, recent guidelines have increased the threshold for defining low levels of HDL for both men and women. The first step in achieving these revised targets is therapeutic lifestyle changes. When these measures are inadequate, pharmacotherapy specific to the patient's lipid profile should be instituted. Niacin therapy, currently the most effective means for raising HDL levels, should be initiated in patients with isolated low HDL (HDL <40 mg/dL, LDL and non-HDL at or below National Cholesterol Education Program (NCEP) targets based on global cardiovascular risk evaluation). Patients who have both low HDL and elevated LDL should receive a statin or statin-niacin combination therapy, and patients with concomitant low HDL and elevated TGs should receive a fibrate initially, with a statin, niacin, or ezetimibe added thereafter as needed to help attain NCEP lipoprotein targets. |
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Authors:
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Peter P Toth |
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Publication Detail:
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Type: Journal Article; Review Date: 2005-09-15 |
Journal Detail:
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Title: The American journal of cardiology Volume: 96 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-11-18 Completed Date: 2005-12-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 50K-58K; discussion 34K-35K Citation Subset: AIM; IM |
Affiliation:
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Sterling Rock Falls Clinic, Sterling, Illinois 61081-1252, USA. peter.toth@srfc.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antilipemic Agents
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adverse effects,
therapeutic use* Atherosclerosis / etiology, prevention & control* Cardiovascular Diseases / etiology, prevention & control* Cholesterol, HDL / blood* Cholesterol, LDL / blood* Female Humans Life Style Male Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Antilipemic Agents; 0/Cholesterol, HDL; 0/Cholesterol, LDL |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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