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Drugs Affecting High-Density Lipoprotein and Triglyceride Metabolism

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Drugs Affecting Lipid Metabolism

Part of the book series: Medical Science Symposia Series ((MSSS,volume 2))

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Abstract

Both observational and interventional epidemiological data have established plasma level of high-density lipoprotein cholesterol (HDL-C) as a strong independent, inverse predictor of the development of coronary heart disease (CHD) [1,2]. The first major clinical trial to demonstrate q significant correlation between raising HDL-C level and lowering the incidence of CHD events was the 5-year, randomized, double-blind Helsinki Heart Study, which used diet plus gemfibrozil versus diet plus placebo in symptom-free dyslipidemic men [3]. It is also the Helsinki data set that has recently provided evidence that highest risk for CHD entails elevation of plasma triglyceride: reanalysis showed the highest risk (and greatest treatment benefit) among patients who had q low-density lipoprotein cholesterol (LDL-C) to HDL-C ratio of more than 5 and a triglyceride level of more than 200 mg/dl (2.3 mmol/L) [4]. Highest risk by a like stratification (total to HDL cholesterol ratio > 5, HDL-C <35 mg/dl [0.91 mmol/L], triglyceride ^200 mg/dl) was found in 4-year data from the observational Prospective Cardiovascular Münster (PROCAM) study [5]. However, the relation between plasma triglyceride level and CHD remains unclear; whether hypertriglyceridemia may be a causative factor or merely a marker for CHD is debated on both metabolic and epidemiological grounds [6].

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Authors
  1. A. M. Gotto Jr.
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Editors and Affiliations

  1. Istituto di Scienze Farmacologiche, Università di Milano, Via Balzaretti 9, I-20133, Milano, Italy

    A. L. Catapano  & Rodolfo Paoletti (Direttore) &  (Direttore)

  2. Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA

    A. M. Gotto Jr. (Chairman) (Chairman)

  3. Department of Medicine, The Methodist Hospital, 6565 Fannin M.S. A601, Houston, TX, 77030-2797, USA

    Louis C. Smith (Professor of Experimental Medicine) (Professor of Experimental Medicine)

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Gotto, A.M. (1993). Drugs Affecting High-Density Lipoprotein and Triglyceride Metabolism. In: Catapano, A.L., Gotto, A.M., Smith, L.C., Paoletti, R. (eds) Drugs Affecting Lipid Metabolism. Medical Science Symposia Series, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-1703-6_27

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  • DOI: https://doi.org/10.1007/978-94-011-1703-6_27

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