Raising high-density lipoprotein cholesterol for better prevention of cardiovascular disease

A substantial body of evidence supports the benefits of lipid lowering on cardiovascular outcome. As a consequence, statin therapy has emerged as the foundation for management of dyslipidemia in high-risk patients. Despite these achievements, two-thirds of cardiovascular events cannot be prevented by lowering low-density lipoprotein (LDL) cholesterol levels according to current guidelines. Although LDL remains one of the most important factors in atherogenesis, research has shifted beyond the LDL particle and includes other lipoproteins that may contribute to cardiovascular disease risk, such as low levels of high-density lipoprotein (HDL) cholesterol and elevated triglycerlde (TG) levels. Together with the growing epidemic of obesity-induced dyslipidemia, mainly consisting of low HDL levels and elevated TGs, strategies to increase HDL levels are beginning to emerge as an attractive tool for better cardiovascular protection. In the future, a comprehensive approach for optimal cardiovascular risk management will probably include both lifestyle modifications and intensive LDL-lowering therapy combined with potent HDL increasing agents