High Density Lipoprotein Cholesterol Comes of Age

Despite the excellent success of lowering low-density lipoprotein cholesterol (LDLc) cholesterol for treating coronary heart disease (CHD), a major part of the population still suffer from CHD. This fact is more prominent among the high risk patients who receive lipid lowering treatment with statins. This treatment is based on the prevailing view that LDL cholesterol (LDLc) is the only important risk factor for CHD. It is well known that HDL plays a crucial role for preventing CHD. Several epidemiologic studies and clinical trials have reported that high density lipoprotein cholesterol (HDLc) is an independent risk factor for CHD as well. A large scale meta-analysis of clinical trials clearly supports that increasing HDLc is equally important as decreasing LDLc, suggesting that physicians should pay attention to increasing HDLc as well as decreasing LDLc. Ongoing trials that are focused on this issue will test this hypothesis in the near future. (Korean Circulation J 2007;37:187-190)