TY - JOUR

T1 - Reevaluating the Role of High-Density Lipoprotein Cholesterol

T2 - New Perspectives on Cardiovascular Disease and Alzheimer Disease

AU - Kjeldsen, Emilie Westerlin

AU - Luo, Jiao

AU - Nordestgaard, Liv Tybjærg

AU - Sandau, Nicolai

AU - Frikke-Schmidt, Ruth

PY - 2023

Y1 - 2023

N2 - High-density lipoprotein (HDL) cholesterol has for decades been considered as the “good cholesterol” due to its inverse association with cardiovascular disease (CVD) risk in observational studies. However, human genetic studies have failed to establish a direct causal association between low HDL cholesterol concentrations and CVD. Moreover, the development of HDL cholesterol-increasing drugs has been pursued, yet their efficacy in reducing cardiovascular risk has been limited. Interestingly, recent studies now uncover unexpected relationships between high HDL cholesterol concentrations and several diseases. These studies, including 2 significant recent investigations, observe associations between high HDL cholesterol concentrations, all-cause mortality, cardiovascular mortality, and Alzheimer disease (1, 2). This perspective aims to summarize and discuss these emerging findings and their potential implications for our understanding of HDL cholesterol and for its use in clinical practice, focusing on the complex interplay between HDL cholesterol, disease risk, and underlying mechanisms.

AB - High-density lipoprotein (HDL) cholesterol has for decades been considered as the “good cholesterol” due to its inverse association with cardiovascular disease (CVD) risk in observational studies. However, human genetic studies have failed to establish a direct causal association between low HDL cholesterol concentrations and CVD. Moreover, the development of HDL cholesterol-increasing drugs has been pursued, yet their efficacy in reducing cardiovascular risk has been limited. Interestingly, recent studies now uncover unexpected relationships between high HDL cholesterol concentrations and several diseases. These studies, including 2 significant recent investigations, observe associations between high HDL cholesterol concentrations, all-cause mortality, cardiovascular mortality, and Alzheimer disease (1, 2). This perspective aims to summarize and discuss these emerging findings and their potential implications for our understanding of HDL cholesterol and for its use in clinical practice, focusing on the complex interplay between HDL cholesterol, disease risk, and underlying mechanisms.

U2 - 10.1093/clinchem/hvad126

DO - 10.1093/clinchem/hvad126

M3 - Journal article

C2 - 37700571

AN - SCOPUS:85178649748

VL - 69

SP - 1329

EP - 1332

JO - Clinical Chemistry

JF - Clinical Chemistry

SN - 0009-9147

IS - 12

ER -