HPS2-THRIVE, AIM-HIGH and dal-OUTCOMES: HDL-cholesterol under attack

INTRODUCTION A low level of high-density lipoprotein cholesterol (HDL-C) is an established predictor of the risk of coronary heart disease (CHD). HDL promotes cellular cholesterol efflux and reverse cholesterol transport from lipid-laden macrophages (Figure 1), and prevents lipoprotein oxidation. A linear inverse relation has been reported in many observational studies between plasma HDL-C level and incident CHD events, with a plateau effect at HDL-C values .90mg/dL in men and 75mg/dL in women.