HDL As A Target For Cardiovascular Protection

Anatol Kontush and M John Chapman explore the role of HDL, focusing on the small, dense form (HDL3), which is thought to have particularly potent effects against cardiovascular disease. Cardiovascular risk is raised in the presence of an imbalance in the types of lipids and lipoproteins circulating in the blood stream, termed dyslipidemia. Dyslipidemia results in an increase in cholesterol-rich apolipoproteins carrying LDL, (a transporter of cholesterol), which in turn can cause fatty deposits to form in blood vessel walls (atherogensis). These deposits can lead to atherosclerosis (hardening of the blood vessel walls), coronary artery disease, and stroke. HDL, on the other hand, encourages excretion of cholesterol from the body via the liver, but in dyslipidemic conditions, the structure of HLD3 particles is altered and its ability to transport cholesterol impaired. Dyslipidemia especially affects people with metabolic diseases, such as type 2 diabetes mellitus, or other metabolic syndromes, although it may be present in people without such disorders.

The authors conclude that it might be possible to capitalize on the potent effects of HDL3 to reduce the risk of cardiovascular disease. Therapy should be targeted not only at increasing the quantity of circulating particles, but also on improving the quality to counteract impairment in performance.

Author contact:
Anatol Kontush (National Institute for Health and Medical Research, Paris, France)
E-mail: kontush@chups.jussieu.fr

Editor contact:
Rachel Ashton (Senior Editor, Nature Clinical Practice Cardiovascular Medicine)
E-mail: r.ashton@nature.com

Abstract available online.

(C) Nature Clinical Practice Cardiovascular Medicine press release.

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