Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Different cholesterol predicts heart risk too, new target for drugs?

23.10.2002


Non-high density lipoprotein cholesterol (non-HDL-C) may help predict heart problems in people who have heart disease, according to a report in today’s Circulation: Journal of the American Heart Association.



Reducing low-density lipoprotein (LDL) cholesterol has long been the goal of medications and other cholesterol-lowering treatments. But researchers are finding that other lipoproteins appear to be involved in developing heart disease. These include some very low-density lipoproteins (VLDL) and intermediate-density lipoproteins (IDL) – which are types of non-HDL cholesterol.

Studies have shown that the general category of "non-HDL" cholesterol, is a strong predictor of heart disease in people who have not yet developed signs of heart problems. As a result, the latest version of the National Cholesterol Education Program (NCEP) guidelines recommends that doctors first target LDL cholesterol, but also pay attention to non-HDL cholesterol.


"LDL cholesterol, even though it is a ’bad’ cholesterol, tells only part of the story," says lead author Vera Bittner, M.D., MSPH, professor of medicine in the division of cardiovascular diseases at the University of Alabama at Birmingham. "We found that while LDL cholesterol is important, the non-HDL cholesterol is the more important predictor – at least in this group of people with heart disease." The researchers studied data compiled previously during the Bypass Angioplasty Revascularization Investigation (BARI) trial, a study that followed 1,514 heart patients (73 percent male, average age 61 years) for five years, taking their cholesterol levels throughout the study period and recording their health histories. The study authors found that non-HDL cholesterol is a strong and independent predictor of non-fatal heart attack and angina (chest pain or discomfort) at five years, even after considering other risk factors, such as age and smoking.

"Our data suggest that non-HDL cholesterol is an appropriate treatment target among patients with coronary disease," the authors say. Specifically, they found that non-HDL was the strongest lipoprotein indicator for non-fatal heart attack and angina among total cholesterol, LDL, triglycerides (a blood fat) and HDL. There was a 4.9 percent increase in risk of heart attack for every 10 milligram per deciliter (mg/dL) increase in non-HDL cholesterol, versus a 4.3 percent increase in risk for every 10 mg/dL of total cholesterol, and a 1.6 percent increase in risk with each 10 mg/dL rise in triglycerides. The increased risk associated with increased LDL levels was not significant. They also found that non-HDL cholesterol had the most profound affect on angina, with a 4.9 percent increased risk for every 10mg/dL rise in non-HDL.

One possible reason that the LDL levels were insignificant in this study, Bittner says, is that many patients with heart disease are already on medications to lower their LDL levels.

"What we have done is purely focused on the LDL and ignored these other particles. This study tells the consumer and physician to look at the entire picture and treat both," she says.

Medications traditionally used to lower LDL, such as statins, tend to affect other lipoproteins only in part, Bittner says. Niacin and some other medications might better treat these particles that have higher triglycerides. Often patients require a combination of medications for the best results.

In an accompanying editorial, Scott M. Grundy, M.D., Ph.D., director of the departments of internal medicine and clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, agrees that non-HDL cholesterol is an important part of the treatment picture. But, he says, it should be a secondary target of therapy until more evidence shows that it’s more important than LDL. Currently, LDL is the main target of cholesterol treatment.

"I think the study shows that non-HDL cholesterol increasingly appears to be a useful predictor of coronary outcomes, and the findings of this study support the NCEP’s new emphasis of non-HDL as a secondary target of treatment after LDL cholesterol," he says.


Co-authors of the study include Regina Hardison; Sheryl F. Kelsey, Ph.D.; Bonnie H. Weiner, M.D.; Alice K. Jacobs, M.D.; and George Sopko, M.D.

Carole Bullock | EurekAlert!
Further information:
http://www.americanheart.org/

More articles from Health and Medicine:

nachricht New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia

nachricht New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

A Map of the Cell’s Power Station

18.08.2017 | Life Sciences

Engineering team images tiny quasicrystals as they form

18.08.2017 | Physics and Astronomy

Researchers printed graphene-like materials with inkjet

18.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>