Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


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


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:

More articles from Health and Medicine:

nachricht Scientists develop tiny tooth-mounted sensors that can track what you eat
22.03.2018 | Tufts University

nachricht NIH scientists describe potential antibody treatment for multidrug-resistant K. pneumoniae
14.03.2018 | NIH/National Institute of Allergy and Infectious Diseases

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: Researchers Discover New Anti-Cancer Protein

An international team of researchers has discovered a new anti-cancer protein. The protein, called LHPP, prevents the uncontrolled proliferation of cancer cells in the liver. The researchers led by Prof. Michael N. Hall from the Biozentrum, University of Basel, report in “Nature” that LHPP can also serve as a biomarker for the diagnosis and prognosis of liver cancer.

The incidence of liver cancer, also known as hepatocellular carcinoma, is steadily increasing. In the last twenty years, the number of cases has almost doubled...

Im Focus: Researchers at Fraunhofer monitor re-entry of Chinese space station Tiangong-1

In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.

Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...

Im Focus: Alliance „OLED Licht Forum“ – Key partner for OLED lighting solutions

Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.

They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...

Im Focus: Mars' oceans formed early, possibly aided by massive volcanic eruptions

Oceans formed before Tharsis and evolved together, shaping climate history of Mars

A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...

Im Focus: Tiny implants for cells are functional in vivo

For the first time, an interdisciplinary team from the University of Basel has succeeded in integrating artificial organelles into the cells of live zebrafish embryos. This innovative approach using artificial organelles as cellular implants offers new potential in treating a range of diseases, as the authors report in an article published in Nature Communications.

In the cells of higher organisms, organelles such as the nucleus or mitochondria perform a range of complex functions necessary for life. In the networks of...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

Virtual reality conference comes to Reutlingen

19.03.2018 | Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

International Tinnitus Conference of the Tinnitus Research Initiative in Regensburg

13.03.2018 | Event News

Latest News

Modular safety concept increases flexibility in plant conversion

22.03.2018 | Trade Fair News

New interactive map shows climate change everywhere in world

22.03.2018 | Earth Sciences

New technologies and computing power to help strengthen population data

22.03.2018 | Earth Sciences

Science & Research
Overview of more VideoLinks >>>