Low HDL-C: key predictor of metabolic syndrome in African American women

New US data highlight racial disparities in awareness of heart disease as a leading cause of death in women. Among African American women only 43% are now aware (1). This is despite a higher prevalence of type 2 diabetes and metabolic syndrome and 2-4-fold greater cardiovascular morbidity and mortality in this group than in white women (2,3).

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Meta-analysis shows positive effects of nicotinic acid on CV events

A therapeutic strategy including nicotinic acid to raise HDL cholesterol is associated with 25% reduction in cardiovascular events, according to a new report in Atherosclerosis.

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Low HDL-C: increasing problem in adolescents

One in five adolescents has abnormal lipids, with low HDL cholesterol accounting for over one-third of abnormal values, according to new data from the National Health and Nutrition Examination Survey (NHANES).

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Niacin restores vasoprotective effects of HDL in type 2 diabetes

High-density lipoprotein (HDL) from patients with type 2 diabetes has impaired vasoprotective effects, compared with HDL in healthy individuals, according to the results of a new study published in Circulation.  However, treatment with extended-release niacin substantially restores the beneficial vasoprotective effects of HDL. These data highlight the need to take account of HDL functionality, as well as plasma HDL cholesterol levels, when assessing the potential of HDL- targeted treatments.

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Low HDL-C is common despite statin therapy

Low high-density lipoprotein cholesterol (HDL cholesterol) is prevalent, affecting over 50% of high-risk statin-treated patients, irrespective of attainment of low-density lipoprotein (LDL) cholesterol goals, according to a recent US observational study. 

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Insights from VOYAGER on statin-induced HDL response

Findings from the VOYAGER meta-analysis have provided insights into the effects of statins on high-density lipoprotein cholesterol (HDL cholesterol). The most important predictor of statin-induced HDL cholesterol response was the pre-treatment level of HDL cholesterol. 

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rHDL attenuates platelet hyperreactivity in type 2 diabetics

Reconstituted high-density lipoprotein (rHDL) reduces the hyperreactivity of platelets of patients with type 2 diabetes, partly by lowering the cholesterol content of platelet membranes, according to a study from the Baker IDI Heart and Diabetes Institute, Australia. These findings suggest possible future therapeutic application in reducing atherothrombotic complications in diabetic patients with acute coronary syndromes.

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HATS, FATS and AFREGS Metsyn analysis highlights need to target HDL

Combined analysis of the FATS (Familial Atherosclerosis Treatment Study), HATS (HDL-Atherosclerosis Treatment Study) and AFREGS (Armed Forces Regression Study) showed that targeting both high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol decreased progression of coronary stenosis by 83% and reduced cardiovascular events by 54% in high-risk patients with metabolic syndrome. These data emphasize the value of combination lipid-modifying therapy in this group.

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HDL-C: An important component of residual cardiovascular risk

A new meta-analysis by researchers at Tufts Medical Center, Boston, USA adds to evidence supporting low plasma levels of high-density lipoprotein cholesterol (HDL cholesterol) as an important contributor to residual cardiovascular risk in statin-treated patients. The data were reported during the American Heart Association Scientific Sessions, Orlando, USA

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Simplifying lipid assessment: non-fasting total and HDL cholesterol

A report from the Emerging Risk Factors Collaboration concludes that measurement of total and high-density lipoprotein cholesterol (HDL cholesterol) or apolipoproteins provides a simple, reliable and practical approach to assessment of vascular risk. Neither fasting lipid levels nor triglycerides provides additional information.

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Analysis of ARBITER 6-HALTS: HDL Forum Editor, Professor Philip Barter

ARBITER 6-HALTS showed that raising high-density lipoprotein (HDL) cholesterol with niacin produces significant regression of atherosclerosis, as assessed by carotid intima-media thickness, in high-risk statin-treated patients at LDL cholesterol goal. In contrast, there was no change in atherosclerosis with further lowering of LDL cholesterol with ezetimibe. The results of ARBITER 6-HALTS were presented at the American Heart Association Scientific Sessions, Orlando, Florida and published simultaneously in the New England Journal of Medicine. HDL Forum Editor Professor Philip Barter reviews and analyses the trial.

 

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New study shows plaque regression with nicotinic acid on top of statin therapy

Results of a new imaging study have provided the first direct evidence that treatment with modified-release nicotinic acid (niacin) reduced carotid atherosclerosis within 12 months vs. placebo in statin-treated patients with low plasma levels of high-density lipoprotein (HDL) cholesterol and clinical evidence of atherosclerotic disease. According to senior author Dr Robin P. Choudhury, ‘This is the first study to show regression in patients taking established best contemporary treatment. The data feed into a bigger understanding of how niacin works.’

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Re-focus on the importance of HDL-C as a therapeutic target

A new analysis of data from the Framingham Offspring study is supportive of the hypothesis that raising levels of high-density lipoprotein (HDL) cholesterol is associated with reduction in cardiovascular risk across the spectrum of patients receiving lipid therapy.

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HDL cholesterol and cardiovascular risk: HDL Forum response to BMJ analysis

A recent systematic review and meta-regression analysis of 108 randomised trials  published in the British Medical Journal, February 16, 2009 concluded that ‘simply increasing the amount of circulating high density lipoprotein (HDL) cholesterol does not reduce the risk of coronary heart disease events, coronary heart disease deaths, or total deaths.’  Here, HDL Forum Editors Kerry-Anne Rye, John Chapman and Philip Barter give their response.

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