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HDL Measurement Provides New Powerful Information

Cholesterol efflux capacity appears to be superior for indicating cardiovascular risk and better target for therapeutic treatments than standard measurements….

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According to groundbreaking research from UT Southwestern Medical Center, cholesterol efflux capacity, which measures HDL cholesterol function, appears to be a superior marker of cardiovascular risk and a better target for therapeutic treatments than standard measurements of HDL. Current measurement methods show only the circulating levels of HDL and not the functional properties of this lipoprotein.

HDL’s major function up to this point is the removal of cholesterol from plaque in the blood vessels and delivery to the liver for excretion. Previously, this function could not be properly measured until, in the new study, Dr. Anand Rohatgi and colleagues at UT Southwestern measured cholesterol efflux in more than 3,000 participants for a multi-ethnic, population-based cohort know as the Dallas Heart Study.

The study found that the measurement of cholesterol efflux provided significantly different information than the standard measure of HDL cholesterol. The findings uncovered a protective relationship between cholesterol efflux and cardiovascular risk. The better a person’s cholesterol efflux, the less likely they will suffer a heart attack, stroke, or death from cardiovascular disease. This association proves to be much stronger for cholesterol efflux than the traditional measurement of HDL cholesterol level.

HDL cholesterol has been considered good cholesterol for a long time because numerous population studies have shown consistent, strong, inverse relationships between HDL levels and risk of heart disease. “Unfortunately, that observation had not translated into effective therapies that target HDL cholesterol,” said Dr. Rohatgi. The treatments that have been shown to raise HDL have not been able to show results that reduce cardiac events.

HDL is very dynamic, and has many functions that are not fully captured by measuring static cholesterol levels according to the authors. An “HDL-function hypothesis” could help us to better understand the effects on cardiovascular risk and provide a better target for therapy to reduce that risk.

Practice Pearls:

  • Study results found that measurement of cholesterol efflux provided significantly different information than the standard measure of HDL cholesterol
  • There is a protective relationship between cholesterol efflux and cardiovascular risk, so the better a person’s cholesterol efflux, the less likely they are to experience a cardiovascular event
  • Researchers are now focused on a “HDL-function hypothesis” to better understand the effects on cardiovascular risk and provide a better target for therapy to reduce that risk

UT Southwestern Medical Center. “New Measurement of HDL Cholesterol Function Provides Powerful Information about Cardiovascular Risk.” The New England Journal of Medicine Web. 18 Nov. 2014.