Open AccessNon‐High‐Density Lipoprotein Cholesterol: Why Lower Is Better
Author(s) -
Garg Rahul,
Vasamreddy Chandrasekhar R.,
Blumenthal Roger S.
Publication year - 2005
Publication title -
preventive cardiology
Language(s) - English
Resource type - Journals
eISSN - 1751-7141
pISSN - 1520-037X
DOI - 10.1111/j.1520-037x.2005.4077.x
Subject(s) - medicine , cholesterol , apolipoprotein b , lipoprotein , endocrinology , reductase , ldl cholesterol , high density lipoprotein , coenzyme a , low density lipoprotein , enzyme , biochemistry , chemistry
Recent comparative trials of 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase inhibitors (statins) suggest that lower is better and that reducing low‐density lipoprotein cholesterol (LDL‐C) levels to below 100 mg/dL can provide additional clinical benefit. Non‐high‐density lipoprotein cholesterol (non‐HDL‐C) contains more atherogenic cholesterol than LDL‐C and is considered a more accurate measurement of the total amount of atherogenic particles in the circulation. Therefore, the principle that “lower is better” may also apply to lowering levels of non‐HDL‐C. In persons with high triglycerides (200–499 mg/dL), LDL‐C remains the primary target of therapy, but non‐HDL‐C is an important secondary therapeutic target. Non‐HDL‐C is strongly correlated with small dense LDL as well as apolipoprotein B, an established predictor of cardiovascular disease risk. Current evidence indicates that statins not only rapidly and dramatically reduce LDL‐C, but also have a similar effect on non‐HDL‐C, and that the greater the reduction in LDL‐C, the greater will be the reduction in non‐HDL‐C.