high-density lipoprotein cholesterol


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high-density lipoprotein cholesterol

See HDL-cholesterol.

cholesterol

(ko-les'te-rol?) [ chole- + sterol]
C27H45OH, a monohydric alcohol; a sterol widely distributed in animal tissues and occurring in egg yolks, various oils, fats, myelin in brain, spinal cord and axons, liver, kidneys, and adrenal glands. It is synthesized in the liver and is a normal constituent of bile. It is the principal constituent of most gallstones and of atherosclerotic plaques found in arteries. It is important in metabolism, serving as a precursor to various steroid hormones (e.g., sex hormones, adrenal corticoids).

An elevated blood level of cholesterol increases a person's risks of developing coronary heart disease (CHD). Lowering elevated total blood cholesterol levels and the levels of low-density lipoprotein cholesterol reduces the risk of heart attacks both in persons with a prior history of coronary disease and in asymptomatic individuals. Risk categories and recommended actions are included in the accompanying table. See: table

Cholesterol levels may be decreased by eating a diet that is low in cholesterol and fat and high in fiber; exercising regularly; and taking medications. Drugs used to control cholesterol levels include lovastatin (and other statins); niacin; and bile-acid resins, e.g., cholestyramine.

high-density lipoprotein cholesterol

See: high-density lipoprotein under lipoprotein.

low-density lipoprotein cholesterol

See: low-density lipoprotein under lipoprotein.

non-HDL cholesterol

The total cholesterol minus the HDL cholesterol. It is a risk factor, independent of other cholesterol measurements, for atherosclerotic vascular disease, esp. in patients with diabetes mellitus, triglyceride levels > 200 mg/dL, or people with the metabolic syndrome.

total cholesterol

The sum of low- and high-density lipoproteins.
*N/A = not applicable. SOURCE: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf, from the Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); National Cholesterol Education Program; National Heart, Lung, and Blood Institute; National Institutes of Health, NIH Pub. No. 02-5215, September 2002.
Suggested Management of Patients with Raised Lipid Levels
• LDL cholesterol is the primary key to treatment. Diet is first-line therapy and drug intervention is reserved for patients considered to be at a higher risk. Continue diet for at least 6 months before initiating drug therapy; use drug therapy in conjunction with diet, not in place of diet. The greater the risk the more aggressive the intervention.
• If there is evidence of coronary heart disease (CHD), do lipoprotein analysis.
• Initially measure total cholesterol and HDL cholesterol levels; based on these results and the presence or absence of other risk factors, determine course of action or proceed to lipoprotein analysis.
• See American Heart Association (AHA) diet, Step I, and AHA diet, Step II.
• Risk factors for atherosclerosis: advanced age, diabetes mellitus, family history, hypertension, male gender, obesity, sedentary lifestyle, tobacco use.
TOTAL AND HDL CHOLESTEROL
Status and Total CholesterolHDL Cholesterol=2 Positive Risk FactorsRecommendations
Desirable (200 mg/dL)=35 mg/dLN/A*• Reassess total and HDL levels in 5 yr.
• Provide information on diet, physical activity, and risk factor reduction.
=35 mg/dLN/A• Do lipoprotein analysis (see below).
Borderline high (200–239 mg/dL)=35 mg/dLNo• Reassess total and HDL levels in 1–2 yr.
• Reinforce diet, physical activity, and other risk factor reduction activities.
=35 mg/dLYes• Do lipoprotein analysis (see below).
High (=240 mg/dL)• Do lipoprotein analysis (see below).
LIPOPROTEIN ANALYSIS
LDL cholesterol = (total cholesterol - HDL) - (triglycerides ÷ 5)
Status and LDL Cholesterol=2 Positive Risk FactorsRecommendations
Desirable (130 mg/dL)N/A• Reassess total and HDL in 5 yr.
• Provide information on diet, physical activity, and risk factor reduction.
Borderline high-risk (130–159 mg/dL)No• Reassess total, HDL, and LDL annually.
• Provide information on Step I diet and physical activity.
High-risk (=160 mg/dL)Yes• Clinical workup (history, physical exam, and lab tests) to check for secondary causes or familial disorders.
• Consider risk factors that can be changed.
• Initiate Step I diet; if diet fails, proceed to Step II diet.
• Consider drug therapy if diet fails to obtain desired levels.
Goal for borderline high-risk patients with =2 negative risk factors is LDL 130 mg/dL.
Goal for high-risk patients with no other risk factors is LDL 160 mg/dL.
• When there is evidence of CHD, the goal of therapy is to reduce LDL to =100 mg/dL.
• LDL > 100—Do clinical workup and initiate diet or drug therapy.
• LDL =100—Individualize instruction on diet and physical activity and repeat lipoprotein analysis annually.
illustration

high-density lipoprotein cholesterol

; HDL cholesterol plasma lipid which appears to protect against atheroma formation and reduce tendency to thrombosis; normal values 0.95-2.15 mmol/L (males) and 0.7-2.0 mmol/L (females)
References in periodicals archive ?
0 LDL-C, low-density lipoprotein cholesterol HDL-C, high-density lipoprotein cholesterol VLDL-C, very-low-density lipoprotein cholesterol
For example, patients receiving diuretics showed less reduction in blood cholesterol levels, had an increase in triglyceride levels, and a slight decrease in high-density lipoprotein cholesterol levels as compared with patients not receiving diuretics.
Furthermore, a significant negative correlation was found between plasma thiamine and all the parameters of lipid profile except high-density lipoprotein cholesterol which had a significant positive correlation.
Inflammatory/antiinflammatory properties of high-density lipoprotein distinguish patients from control subjects better than high-density lipoprotein cholesterol levels and are favorably affected by simvastatin treatment.
High-density lipoprotein cholesterol levels have declined by 10% in a single generation, John A.
1,2] Blood lipids, such as total cholesterol (CH), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and especially low-density lipoprotein cholesterol (LDL-C), become increasingly important in the diagnosis and management of CHD and related diseases.
5%, respectively) and significant increases in high-density lipoprotein cholesterol levels (18.
A physician can obtain a patient's complete lipoprotein profile at the time of the office visit including assays of the total serum cholesterol, high-density lipoprotein cholesterol (HDL-C), and fasting triglyceride concentrations, and then calculate the low-density lipoprotein cholesterol (LDL-C).
HPP593, a functionally selective PPAR-delta agonist, has demonstrated a lowering of low-density lipoprotein cholesterol and triglycerides in animal models and humans, with a significant increase in high-density lipoprotein cholesterol.
Trilipix Capsules are reportedly indicated as an adjunct to diet in combination with a statin to reduce triglyceride and increase high-density lipoprotein cholesterol in patients with mixed dyslipidemia and CHD or a CHD risk equivalent who are on optimal statin therapy to achieve their low-density lipoprotein cholesterol goal.
Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol.

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