scholarly journals Is a High HDL-Cholesterol Level Always Beneficial?

Biomedicines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1083
Author(s):  
Beata Franczyk ◽  
Jacek Rysz ◽  
Janusz Ławiński ◽  
Magdalena Rysz-Górzyńska ◽  
Anna Gluba-Brzózka
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Genetic Disorders ◽  
Hdl Cholesterol ◽  
Epidemiological Studies ◽  
Specific Interest ◽  
Peripheral Tissues ◽  
Causative Relationship ◽  
Ischemic Attack ◽  
And Function

The specific interest concerning HDL cholesterol (HDL-C) is related to its ability to uptake and return surplus cholesterol from peripheral tissues back to the liver and, therefore, to its role in the prevention of cardiovascular diseases, such as atherosclerosis and myocardial infarction, but also transient ischemic attack and stroke. Previous epidemiological studies have indicated that HDL-C concentration is inversely associated with the risk of cardiovascular disease and that it can be used for risk prediction. Some genetic disorders are characterized by markedly elevated levels of HDL-C; however, they do not translate into diminished cardiovascular risk. The search of the potential causative relationship between HDL-C and adverse events has shifted the attention of researchers towards the composition and function of the HDL molecule/subfractions. HDL possesses various cardioprotective properties. However, currently, it appears that higher HDL-C is not necessarily protective against cardiovascular disease, but it can even be harmful in extremely high quantities.

On the clinical significance of HDL cholesterol at the present stage

2021 ◽  
Vol 19 (1) ◽  
pp. 50-53
Author(s):  
V. N. Oslopov ◽  
◽  
Yu. V. Oslopova ◽  
E. V. Khazova ◽  
E. R. Girfanutdinova ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Blood Plasma ◽  
Clinical Studies ◽  
Hdl Cholesterol ◽  
Epidemiological Studies ◽  
Present Stage ◽  
The World ◽  
Cast Doubt ◽  
And Function ◽  
Role And Function

The leading death cause in the world is diseases of the cardiovascular system, with CHD as the leader in the structure of cardiovascular diseases. The cause of this disease is atherosclerosis. One of the possible causes of atherosclerosis is an increase in LDL-C and a decrease in HDL-C in the blood. Many epidemiological studies have reliably shown that HDL cholesterol reduces the risk of developing cardiovascular diseases. Data from recent studies cast doubt on this data. The review briefly describes the current understanding of the effect of HDL-C high levels on morbidity and mortality, lists the new approaches to assessing the role and function of these particles, presents the results of clinical studies of drugs that affect their concentration in blood plasma and the probable causes leading to an increase of the HDL-Cin content in the blood.

Dyslipidaemia

2019 ◽  
pp. 33-48
Author(s):  
Heinz Drexel
Keyword(s):  
Cardiovascular Disease ◽  
Randomized Clinical Trials ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Epidemiological Studies ◽  
Residual Risk ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cholesterol Levels

Lipid metabolism has gained cardiological interest only after statins were demonstrated to reduce cardiovascular disease in secondary and primary prevention. Therefore, this chapter first introduces the physiological and atherogenic properties of lipoproteins, before focusing on interventions. Both the efficacy and safety of statins have been proven in numerous randomized clinical trials. Because there is a considerable residual risk in statin-treated patients, additional approaches have been investigated. The focus is now on further reductions in low-density lipoprotein (LDL) cholesterol levels. First, high-intensity statin regimens were shown to reduce residual risk. Subsequently, ezetimibe was demonstrated, for the first time, to have a beneficial effect as a non-statin lipid intervention. More recently, inhibitors of the enzyme PCSK9 have demonstrated a very high efficacy in reducing LDL cholesterol levels. Although the causality of LDL for atherosclerotic cardiovascular disease has been proven in epidemiological studies, including Mendelian randomization studies, as well as interventional trials, adherence to statins and other therapies is far from optimal. In contrast, interventions to increase high-density lipoprotein (HDL) cholesterol levels could not proven to have further benefits when combined with statins.

scholarly journals Interaction between adipocytes and high-density lipoprotein:new insights into the mechanism of obesity-induced dyslipidemia and atherosclerosis

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Tianhua Zhang ◽  
Jin Chen ◽  
Xiaoyu Tang ◽  
Qin Luo ◽  
Danyan Xu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Adipose Tissue ◽  
Hormone Secretion ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
High Density ◽  
Atherosclerotic Cardiovascular Disease ◽  
Nutritional Disorder ◽  
Hdl Function ◽  
And Function

AbstractObesity is the most common nutritional disorder worldwide and is associated with dyslipidemia and atherosclerotic cardiovascular disease. The hallmark of dyslipidemia in obesity is low high density lipoprotein (HDL) cholesterol (HDL-C) levels. Moreover, the quality of HDL is also changed in the obese setting. However, there are still some disputes on the explanations for this phenomenon. There is increasing evidence that adipose tissue, as an energy storage tissue, participates in several metabolism activities, such as hormone secretion and cholesterol efflux. It can influence overall reverse cholesterol transport and plasma HDL-C level. In obesity individuals, the changes in morphology and function of adipose tissue affect plasma HDL-C levels and HDL function, thus, adipose tissue should be the main target for the treatment of HDL metabolism in obesity. In this review, we will summarize the cross-talk between adipocytes and HDL related to cardiovascular disease and focus on the new insights of the potential mechanism underlying obesity and HDL dysfunction.

scholarly journals Novel Insights From Human Studies on the Role of High-Density Lipoprotein in Mortality and Noncardiovascular Disease

2020 ◽  
Author(s):  
Christian M. Madsen ◽  
Anette Varbo ◽  
Børge G. Nordestgaard
Keyword(s):  
Cardiovascular Disease ◽  
High Density Lipoprotein ◽  
Therapeutic Potential ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
High Density ◽  
Cancer Type ◽  
Health And Disease ◽  
And Function

The vast majority of research about HDL (high-density lipoprotein) has for decades revolved around the possible role of HDL in atherosclerosis and its therapeutic potential within cardiovascular disease prevention; however, failures with therapies aimed at increasing HDL cholesterol has left questions as to what the role and function of HDL in human health and disease is. Recent observational studies have further shown that extreme high HDL cholesterol is associated with high mortality leading to speculations that HDL could in some instances be harmful. In addition, evidence from observational, and to a lesser extent genetic, studies has emerged indicating that HDL might be associated with the development of other major noncardiovascular diseases, such as infectious disease, autoimmune disease, cancer, type 2 diabetes, kidney disease, and lung disease. In this review, we discuss (1) the association between extreme high HDL cholesterol and mortality and (2) the emerging human evidence linking HDL to several major diseases outside the realm of cardiovascular disease.

scholarly journals CORRELATION OF SERUM HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND HOMOCYSTEINE LEVEL IN PATIENT WITH ACUTE MYOCARDIAL INFARCTION

2019 ◽  
Vol 25 (1) ◽  
pp. 99
Author(s):  
Yayie Dwina Putri ◽  
Tuty Prihandani ◽  
Lillah Lillah ◽  
Rismawati Yaswir
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
High Density Lipoprotein ◽  
Homocysteine Level ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
High Density ◽  
The Mean ◽  
Spearman’S Correlation

Acute Myocardial Infarction (AMI), one of the primary manifestation of coronary heart disease, is a significat cause of death worldwide. Hyperhomocysteinemia, a risk factor for cardiovascular disease, is caused by nutritional or genetic disturbances in homocysteine metabolism. The role of hyperhomocysteinemia in altered lipid metabolism presumed holds the key to an increased risk of cardiovascular disease. Hyperhomocysteinemia causes the reduction of serum High-Density Lipoprotein (HDL) cholesterol level by inhibiting hepatic synthesis of apo-A1 (significant apolipoprotein HDL). The aim of this study was to know the correlation between hyperhomocysteinemia and decreased HDL cholesterol levels for the management of cardiovascular disease risk factors. This research was an analytical study with cross-sectional design in 40 patients AMI who meet the inclusion and exclusion criteria and conduct blood test at the Central Laboratory of Hospital Dr. M. Djamil Padang and Biomedical Laboratory Faculty of Medicine Andalas University. The study was conducted in May 2016-Agustus 2017. Homocysteine level was measured by ELISA method. High-Density Lipoprotein level was performed by enzymatic colorimetric method. Data were analyzed by Spearman’s correlation test. Research subjects were 40 people with male gender 30 (75%) and female 10 (25%), mean age 61.08 (11.09) year. The mean level of HDL cholesterol in patients with AMI is 41.93 ± 13.12 mg/dL. The mean level of homocysteine in patients with AMI is 25.36 ± 22.2 µmol/L. Spearman’s correlation test showed a strong correlation between the levels of homocysteine and HDL cholesterol with r=-0.603 and p<0.01.

Intensive cardiovascular care units: structure, organization, and staffing

2021 ◽  
pp. 11-24
Author(s):  
Eric Bonnefoy-Cudraz ◽  
Tom Quinn
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Working Group ◽  
Life Threatening ◽  
Coronary Care ◽  
The 1960S ◽  
And Function ◽  
Cardiovascular Care

The nature and complexity of acute cardiovascular care has changed markedly since the early days of the coronary care unit (CCU), introduced in the 1960s to prevent and treat life threatening arrhythmias associated with acute myocardial infarction. In the present day, the patient population is older, has more multimorbidity, comprises a range of conditions alongside critical cardiovascular disease and associated multi-organ failure, requiring increasingly sophisticated management. To reflect this, the Acute Cardiovascular Care Association (ACCA) published a comprehensive update of recommendations in 2018, developed by a multinational working group of experts. These recommendations, which inform this chapter, address the definition, structure, organisation and function of the contemporary intensive cardiovascular care unit (ICCU). Reflecting the modern casemix, three levels of acuity of care are described, and corresponding requirements for ICCU organisation defined. Recommendations on ICCU staffing (medical, nursing and allied professions), equipment and architecture, are presented, alongside considerations of the role of the ICCU within the wider hospital and cardiovascular care network.

scholarly journals 9-cis β-carotene Inhibits Atherosclerosis Development in Female LDLR-/- Mice

2015 ◽  
Vol 5 (2) ◽  
pp. 67 ◽  
Author(s):  
Noa Zolberg Relevy ◽  
Ralph Rühl ◽  
Ayelet Harari ◽  
Itamar Grosskopf ◽  
Iris Barshack ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Retinoic Acid ◽  
High Fat Diet ◽  
Plasma Cholesterol ◽  
Ldl Receptor ◽  
Hdl Cholesterol ◽  
Epidemiological Studies ◽  
Chow Diet ◽  
High Fat ◽  
Β Carotene

Background: Several epidemiological studies have shown that diets rich in carotenoids are associated with a reduced risk of cardiovascular disease. However, administration of synthetic all-trans b-carotene was reported to have no effect on cardiovascular disease. We previously showed that the 9-cis b-carotene-rich powder of the alga Dunaliella bardawil inhibits atherogenesis and reduces plasma non-HDL cholesterol levels in mice.Context and purpose of this study: We sought to study whether isolated 9-cis b-carotene inhibits atherogenesis in a murine model of atherosclerosis.Results: Twelve-week-old female LDL receptor knockout mice (LDLR-/-) were pretreated for  2 weeks with regular chow diet fortified with the alga Dunaliella powder, 9-cis β-carotene isomer, all-trans β-carotene isomer, or 9-cis retinoic acid, followed by 10 weeks of a high-fat diet with the same fortifications. In contrast to Dunaliella, 9-cis β-carotene did not inhibit the high fat diet-induced elevation of plasma cholesterol. In addition, diet fortification with Dunaliella powder, β-carotene isomers, or 9-cis retinoic acid did not change the plasma retinol or retinoic acid levels. Nevertheless, 9-cis β-carotene significantly inhibited atherogenesis compared to the control mice (39% reduction).Conclusions: The results suggest that 9-cis β-carotene should be considered as an anti-atherogenic agent in the human diet.Key words: Atherosclerosis, Dunaliella, 9CBC, LDLR-/- mice  

Lipid disorders

2020 ◽  
pp. 2055-2097
Author(s):  
Jaimini Cegla ◽  
James Scott
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Lipoprotein Metabolism ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Dietary Lipid ◽  
Atherosclerotic Cardiovascular Disease ◽  
Peripheral Tissues ◽  
Lipid Disorders ◽  
Triglyceride Rich Lipoprotein

High blood cholesterol and high blood triglycerides are causal risk factors for atherosclerotic cardiovascular disease, which remains the leading cause of death in the developed world. Lipid and lipoprotein metabolism—cholesterol, triglycerides, and fat-soluble vitamins are transported with specific proteins in the blood as multimeric complexes called lipoproteins. Lipid and lipoprotein metabolism are effected by three principal physiological processes: (1) intestinal absorption of dietary lipid and transport in the blood of dietary lipid and lipids, principally derived from the liver (as triglyceride-rich lipoproteins) to peripheral tissues for catabolism by skeletal and cardiac muscle or storage in adipose tissue; (2) return of triglyceride-rich lipoprotein remnants to the liver, hepatic synthesis of low-density lipoprotein, and the transport of cholesterol between peripheral tissues and the liver; and (3) reverse cholesterol transport by high-density lipoprotein (HDL) between peripheral tissues and the liver. Dyslipidaemias are disorders of lipoprotein metabolism in which there is elevation of total cholesterol and/or triglycerides, often accompanied by reduced levels of HDL cholesterol. Causes of dyslipidaemia—particular lipid disorders including polygenic hypercholesterolaemia, familial hypercholesterolaemia, combined hypercholesterolaemia and hypertriglyceridaemia, familial combined hyperlipidaemia, familial dysbetalipoproteinaemia (also called type 3 hyperlipoproteinaemia), and severe hypertriglyceridaemia, as well as secondary or aggravating factors. Management of dyslipidaemia—the key questions are: (1) what classes of lipoproteins and lipids are increased or decreased in the patient’s plasma? (2) Does the patient has a primary (genetic) or secondary (acquired) dyslipidaemia (often contributions from both influences)? (3) Is the patient at risk of atherosclerotic cardiovascular disease or acute pancreatitis? (4) What other risk factors (e.g. hypertension or diabetes) are present? (5) What treatments might be used to address these abnormalities?

Cardiovascular Disease

2017 ◽  
Author(s):  
David A. Wohl ◽  
Jeffrey T. Kirchner
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Epidemiological Studies ◽  
Antiretroviral Drugs ◽  
Lipid Lowering ◽  
Cvd Risk ◽  
Antihypertensive Medications ◽  
Increased Risk ◽  
Immunologic Control ◽  
Lipid Lowering Agents

There is a growing body of evidence that HIV-infected persons are at increased risk for cardiovascular disease (CVD) and associated complications, including myocardial infarction and stroke. Autopsy studies have noted premature atherosclerosis in HIV-infected adults, and epidemiological studies demonstrate higher rates of CVD among HIV-infected compared to HIV-uninfected patients. These findings are in part due to chronic inflammation and immune activation associated with HIV infection. Traditional CVD risk factors, including hypertension, hyperlipidemia, and cigarette smoking, also play keys roles. There is additional evidence from observational cohort studies that some antiretroviral drugs, including protease inhibitors and nucleoside reverse transcriptase inhibitors, may increase the risk of myocardial infarction. Treatment interventions to reduce the risk of CVD include diet, exercise, smoking cessation, lipid-lowering agents, and antihypertensive medications. For select patients, changing antiretroviral therapy to improve lipid profiles may be appropriate but should not compromise virologic or immunologic control.

scholarly journals The Role and Function of HDL in Patients with Chronic Kidney Disease and the Risk of Cardiovascular Disease

2020 ◽  
Vol 21 (2) ◽  
pp. 601 ◽  
Author(s):  
Jacek Rysz ◽  
Anna Gluba-Brzózka ◽  
Magdalena Rysz-Górzyńska ◽  
Beata Franczyk
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Oxidized Ldl ◽  
Lipoprotein Metabolism ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Cholesterol Concentration ◽  
Peripheral Tissues ◽  
Cardiovascular Morbidity And Mortality

Chronic kidney disease (CKD) is a worldwide health problem with steadily increasing occurrence. Significantly elevated cardiovascular morbidity and mortality have been observed in CKD. Cardiovascular diseases are the most important and frequent cause of death of CKD patients globally. The presence of CKD is related to disturbances in lipoprotein metabolism whose consequences are dyslipidemia and the accumulation of atherogenic particles. CKD not only fuels the reduction of high-density lipoprotein (HDL) cholesterol concentration, but also it modifies the composition of this lipoprotein. The key role of HDL is the participation in reverse cholesterol transport from peripheral tissues to the liver. Moreover, HDL prevents the oxidation of low-density lipoprotein (LDL) cholesterol by reactive oxygen species (ROS) and protects against the adverse effects of oxidized LDL (ox-LDL) on the endothelium. Numerous studies have demonstrated the ability of HDL to promote the production of nitric oxide (NO) by endothelial cells (ECs) and to exert antiapoptotic and anti-inflammatory effects. Increasing evidence suggests that in patients with chronic inflammatory disorders, HDLs may lose important antiatherosclerotic properties and become dysfunctional. So far, no therapeutic strategy to raise HDL, or alter the ratio of HDL subfractions, has been successful in slowing the progression of CKD or reducing cardiovascular disease in patients either with or without CKD.

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