Increase hdl cholesterol
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HDL Cholesterol and Cardiovascular Health
High-density lipoprotein (HDL) cholesterol is well known for its protective role against coronary heart disease and stroke. Higher HDL cholesterol levels are linked to a lower risk of cardiovascular events, making strategies to increase HDL a focus of research and therapy development 126.
Drug Therapies to Increase HDL Cholesterol
Several drug classes have been developed to raise HDL cholesterol. Cholesteryl ester transfer protein (CETP) inhibitors, such as torcetrapib, can significantly increase HDL cholesterol levels. However, despite raising HDL, these drugs have not consistently shown a reduction in cardiovascular events, leading to questions about the effectiveness of simply increasing HDL cholesterol without improving its function 12710. Other medications, including statins, fibrates, and niacin, also increase HDL cholesterol to varying degrees, but their impact on cardiovascular outcomes remains controversial 2710.
Importance of HDL Functionality
Recent research emphasizes that the functionality of HDL particles may be as important as, or even more important than, the absolute HDL cholesterol level. HDL particles are involved in reverse cholesterol transport, anti-inflammatory processes, and other protective mechanisms. Some therapies, such as apolipoprotein A1 (ApoA1) infusions, have been shown to improve HDL function and promote cholesterol efflux, which may be more beneficial than simply raising HDL cholesterol levels 27810.
Dietary Approaches to Raising HDL Cholesterol
Diet can also influence HDL cholesterol. Clinical trials have shown that almond supplementation (10 g/day) can significantly increase HDL cholesterol by 12-16% in patients with low baseline HDL, without affecting body weight or blood pressure . Meta-analyses suggest that dietary cholesterol intake has a modest effect on HDL cholesterol, with some evidence of a positive association in women, though the clinical significance is uncertain . In animal studies, a high-fat/high-cholesterol diet increased HDL cholesterol and promoted cholesterol efflux from the liver, suggesting that both dietary fat and cholesterol can influence HDL levels .
Population Trends and Lifestyle Factors
Long-term population studies in Japan have documented a steady increase in HDL cholesterol over several decades, but the reasons for this trend are not fully understood. Factors such as fish and meat intake, smoking, alcohol consumption, and body mass index only partially explain the increase, indicating that other, unidentified factors may be involved .
Conclusion
While raising HDL cholesterol remains an attractive goal for reducing cardiovascular risk, current evidence suggests that improving HDL functionality and targeting specific HDL subclasses may be more important than simply increasing HDL cholesterol levels. Drug therapies, dietary interventions, and lifestyle changes can all influence HDL, but their impact on cardiovascular outcomes depends on both the quantity and quality of HDL particles 1247810. Ongoing research is needed to identify the most effective strategies for harnessing the protective effects of HDL cholesterol.
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