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HDL and CVD Risk: The Current Understanding

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Dr Akshay Mehta, Mumbai    06 January 2018

  1. However, two streams of information suggest that though it may be epidemiologically related to CVD, it is not causally related. Thus although it is an important risk marker, it may not be a causally related risk factor.
  2. One is the series of negative therapeutic trials and the other is multiple Mendelian randomization studies, which have shown lack of correlation between levels of HDL-C and incident CHD. In fact, these studies have shown that it is not the ‘amount’ of cholesterol with HDL that is related to CHD incidence but four factors related to the HDL particle that impact the risk of CAD namely, composition, function, size and number of HDL particles.
  3. Hence future efforts at preventing CHD should concentrate on modifying these aspects of HDL particles, rather than modifying the amount of HDL-C.

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