HDL Conundrum with Dr John J.P. Kastelein

Dr. Bouchard discusses ” THE HDL CHOLESTEROL CONUNDRUM” with Dr. John J.P. Kastelein, M.D., Ph.D., FESC, Professor of Medicine, University of Amsterdam.

For the last 15 yrs, multiple randomized controlled trials have attempted to improve clinical outcomes by raising HDL cholesterol and have failed to achieve any significant results. The studies of niacin and fibrates have shown that HDL can be raised modestly but had no clinical impact on cardiovascular events. ILLUMINATE studied torcetrapib, a CETP inhibitor that can raise HDL cholesterol by 72% and reduce LDL by 25%. Torcetrapib vs placebo was given for 12 months in patients with a high risk of ASCVD. Surprisingly, the study showed an increase in cardiovascular mortality secondary to off-target effects like raising blood pressure and aldosterone and lowering potassium.

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