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HDL & Reverse Cholesterol Transport [HD]

Updated Comments: August 2017 publication in EHJ shows very high HDL predicts an increased mortality risk (see more details below…)

As shown in older studies (AIM-HIGH & HPS2-THRIVE), HDL-C increase alone cannot be associated to cardiovascular benefits, especially when LDL-C is very low. HDL-C remains a marker to assess cardiovascular risk but not a Risk Factor: meaning that raising HDL-C is not proven to provide benefit.

A recent data analysis published on August 2017 in the European Heart Journal by Madsen et al. (Eur Heart J 2017;38:2478–2486) referring to the Copenhagen City Heart Study and the Copenhagen General Population Study has shown that the presence of an extremely high concentration of HDL cholesterol is predictive of an increase in all-cause mortality in both men and women. This analysis included 52.268 men and 64.240 women and shows a U-shaped relationship between HDL cholesterol concentration and mortality, with an increased risk observed at both low levels and very high levels of HDL cholesterol. The lowest mortality was observed with HDL cholesterol levels of 73.5mg/dL (1.9 mmol/L) in men and 92.8mg/dL (2.4 mmol/L) in women.

Complexity of HDL-C functions does not allow simplifications such as to determine CV Benefit just from HDL-C concentration (eg: mg/dL) modifications. Number and size of HDL-C particles, concentration of Apo-A1, and the actual Reverse Cholesterol Efflux need to be considered. More trials are underway to finally conclude on this matter.

LDL-C remains the primary treatment target (recent guidelines also mention non-HDL and Apo-B as secondary targets).

DISCLAIMER: This educational video was not developed nor is it copyrighted by this Channel.


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  1. It is Super !! Thanks for great clip ..

  2. My cholesterol is 5.4 mmol (or pmol?), considered very high. Male, age 30, eat healthy diet, exercise 6 days a week (7+ hours). What's wrong with me?

  3. Nice that these videos are made, and so easy to understand.

  4. Nice video. I'm also looking for an explanation on how reducing LDL-C through statin therapy improves CV risk. Since LDL-C is just a transport mechanism and from my understanding it's more of an inflamation marker.. what does it mean, that statins reduce inflamation first and LDL-C drops as a consequence of that. Why other anti-inflammatory medication do not have this effect?

  5. Thankssssssss you saved my marks in biochemistry

  6. nice video and thanks a lot

  7. u.u por que no está en español ..

  8. Reversing cholesterol Transport – I don't know about that;
    but I do know what cholesterol pockets (and lines) on
    my eyes is; I never had this before! But – I had run out of
    my oil vitamins, and my Apple Pectin; and – I have found, and
    added to it – lecithin! The animal one! I want to fight fire with
    Lecithin For Cholesterol! Liver and Bones!
    Can't Beat These Jokes With A Stick!
    I tried!!!
    Who's Who?
    Steve McQueen coming Wednesday!!!

  9. HDL can reduce plague in artery?

  10. شكرا جزيلا لكم على هذا المجهود الرائع والمتقن

  11. This is super clear, thank you 🙂

  12. My 3rd year Pharmacology exam brought me here. I'm a little less doomed.

  13. Amazing animation. But can anyone verify the information in it is correct?

  14. Awesome! Who sponsored the development of the animation?

  15. hyperalphalipoproteinemia brought me here…

    My hdl is 169… 

  16. A very clear presentation thanks.  Please, if you can assist, for what percentage of Cholesterol reverse transport does SR-B1 (scavenger receptor B1) account, perhaps compared with LDL receptors? 

  17. tq sooooooo much…………….

  18. tq sooooooo much…………….

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