Researchers evaluate cholesterol’s potential to prevent cardiovascular disease

A new study assessed HDL’s anti-inflammatory ability to reduce cardiovascular events. The results were published in the journal Circulation.

Research in recent years has confirmed that HDL may reduce the risk of heart attack and stroke. These results were attributed to the quantitative content of HDL.

At the same time, researchers from Karolinska Institutet concluded that high levels of HDL in the blood are not as closely associated with cardiovascular outcomes as previously thought. So in the new study, the researchers shifted their focus from HDL concentration levels to their functionality.

Dutch researchers examined the relationship between HDL’s ability to reduce inflammation and the risk of a first cardiovascular event.

The analysis included participants from a larger study, The PREVEND (Prevention of Renal and Vascular End Stage Disease), which had already taken place in 1997–2002. The key parameter for selection was the presence of a first cardiovascular event during the follow-up period. The total number of study participants was 40,856, of whom 680 participants were recruited to create two case-control groups of 340 each.

Evaluation of the anti-inflammatory capacity of HDL was performed in vitro by measuring the suppression of tumor necrosis factor TNF-α induced by vascular cell adhesion molecule 1 (VCAM-1). The result was assessed as the achieved percentage of reduction in mRNA relative to the maximum amount of factor in the absence of HDL.

The anti-inflammatory capacity of HDL was 31.6% higher in people who had no cardiovascular events during follow-up, compared with 27% in those who had a cardiovascular event.

Every 22% increase in HDL’s inflammation-lowering potential means a 23% decrease in heart attack risk over the next 10 years.

“New research approaches and tools have made it possible to confirm the idea that atherosclerosis is largely due to the occurrence of inflammation in blood vessels and that the biological activity of HDL molecules has important clinical significance in predicting cardiovascular risk,” commented one of the researchers, Dr. Uwe J.F. Tietge (Dr. Uwe JF Tietge).

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