Increasing HDL-cholesterol and prevention of atherosclerosis: A critical perspective
Abstract
The relationship between atherosclerosis and HDL is more complex than between LDL and atherosclerosis. Low HDL-cholesterol is associated with atherosclerotic disease not in a causal way but because low HDL-cholesterol reflects an increased concentration of triglyceride-rich lipoproteins. At the same time the functionality of the HDL system plays an important role in atherosclerosis prevention (for example by mediating reverse cholesterol transport). However, these two observations are not directly linked to each other. Therefore therapeutic strategies must either aim at decreasing the concentration of triglyceride-rich lipoproteins (and thereby increase HDL-cholesterol concentration) or at improving HDL function (which may or may not affect HDL-cholesterol concentration). Simply increasing HDL-cholesterol concentration without improving function or decreasing triglyceride-rich lipoproteins will not be beneficial with respect to atherosclerosis prevention.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Recent approaches primarily aim to optimise the function of HDL in RCT.
“Recent approaches primarily aim to optimise the function of HDL in RCT [110, 111].”
From HDL cholesterol: reappraisal of its clinical relevance (2017) · cites this paper as [110]
Cites
Cholesterol Treatment Trialists' (CTT) Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)61350-5 · Cited by 6,550 · see citing works
Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy
The AIM-HIGH Investigators (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1107579 · Cited by 2,911 · see citing works
Effects of Combination Lipid Therapy in Type 2 Diabetes Mellitus
(2010) · New England Journal of Medicine · doi:10.1056/nejmoa1001282 · Cited by 2,837 · see citing works
Explaining the decrease in U.S. deaths from coronary disease, 1980–2000
Ford, E. S., Ajani, U. A., Croft, J. B., Critchley, J. A., Labarthe, D. R., Kottke, T. E., Giles, W. H., & Capewell, S. (2007) · New England Journal of Medicine · doi:10.1056/nejmsa053935 · Cited by 2,757 · see citing works
Major lipids, apolipoproteins, and risk of vascular disease
The Emerging Risk Factors Collaboration* (2009) · JAMA · doi:10.1001/jama.2009.1619 · Cited by 2,731 · see citing works
Effects of dalcetrapib in patients with a recent acute coronary syndrome
Schwartz, G. G., Olsson, A. G., Abt, M., Ballantyne, C. M., Barter, P. J., Brumm, J., Chaitman, B. R., Holme, I. M., Kallend, D., Leiter, L. A., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1206797 · Cited by 2,022 · see citing works
Cholesterol efflux capacity, high-density lipoprotein function, and atherosclerosis
Khera, A. V., Cuchel, M., de la Llera-Moya, M., Rodrigues, A., Burke, M. F., Jafri, K., French, B. C., Phillips, J. A., Mucksavage, M. L., Wilensky, R. L., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1001689 · Cited by 1,943 · see citing works
Cardiovascular disease in Europe: epidemiological update
Nichols, M. S., Townsend, N. P., Scarborough, P., & Rayner, M. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht356 · Cited by 1,349 · see citing works
Remnant Cholesterol as a Causal Risk Factor for Ischemic Heart Disease
Varbo, A., Benn, M., Tybjærg-Hansen, A., Jørgensen, A. B., Frikke-Schmidt, R., & Nordestgaard, B. G. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.08.1026 · Cited by 1,115 · see citing works
Loss-of-Function Mutations in <i>APOC3,</i> Triglycerides, and Coronary Disease
The TG and HDL Working Group of the Exome Sequencing Project, N. H. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1307095 · Cited by 1,071 · see citing works
Effects of fibrates on cardiovascular outcomes: a systematic review and meta-analysis
Jun, M., Foote, C., Lv, J., Neal, B., Patel, A., Nicholls, S. J., Grobbee, D. E., Cass, A., Chalmers, J., & Perkovic, V. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60656-3 · Cited by 933 · see citing works
Loss-of-Function Mutations in <i>APOC3</i> and Risk of Ischemic Vascular Disease
Jørgensen, A. B., Frikke-Schmidt, R., Nordestgaard, B. G., & Tybjærg-Hansen, A. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1308027 · Cited by 919 · see citing works
Li-ya, W., & Parhofer, K. G. (2014) · Metabolism · doi:10.1016/j.metabol.2014.08.010 · Cited by 523 · see citing works
Self-citationKeene, D., Price, C., Shun-Shin, M. J., & Francis, D. P. (2014) · BMJ · doi:10.1136/bmj.g4379 · Cited by 519 · see citing works
Sorrentino, S. A., Besler, C., Rohrer, L., Meyer, M., Heinrich, K., Bahlmann, F. H., Mueller, M., Horváth, T., Doerries, C., Heinemann, M., et al. (2010) · Circulation · doi:10.1161/circulationaha.108.836346 · Cited by 402 · see citing works
Lüscher, T. F., Landmesser, U., von Eckardstein, A., & Fogelman, A. M. (2014) · Circulation Research · doi:10.1161/circresaha.114.300935 · Cited by 292 · see citing works
Nichols, M. S., Townsend, N. P., Scarborough, P., & Rayner, M. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht159 · Cited by 289 · see citing works
Besler, C., Lüscher, T. F., & Landmesser, U. (2012) · EMBO Molecular Medicine · doi:10.1002/emmm.201200224 · Cited by 219 · see citing works
Kratzer, A., Giral, H., & Landmesser, U. (2014) · Cardiovascular Research · doi:10.1093/cvr/cvu139 · Cited by 109 · see citing works
Adams, V., Besler, C., Fischer, T., Riwanto, M., Noack, F., Höllriegel, R., Oberbach, A., Jehmlich, N., Völker, U., Winzer, E. B., et al. (2013) · Circulation Research · doi:10.1161/circresaha.113.301684 · Cited by 91 · see citing works
Flagged first, then by citations
1 of the 22 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
HDL cholesterol: reappraisal of its clinical relevance
März, W., Kleber, M. E., Scharnagl, H., Speer, T., Zewinger, S., Ritsch, A., Parhofer, K. G., von Eckardstein, A., Landmesser, U., & Laufs, U. (2017) · Clinical Research in Cardiology · doi:10.1007/s00392-017-1106-1 · Cited by 275 · see citing works
Self-citationHypertriglyceridemia and atherosclerosis
Peng, J., Luo, F., Ruan, G., Peng, R., & Li, X. (2017) · Lipids in Health and Disease · doi:10.1186/s12944-017-0625-0 · Cited by 262 · see citing works
The Association between the Lipids Levels in Blood and Risk of Age-Related Macular Degeneration
Wang, Y., Wang, M., Zhang, X., Zhang, Q., Nie, J., Zhang, M., Liu, X., & Ma, L. (2016) · Nutrients · doi:10.3390/nu8100663 · Cited by 87 · see citing works
Toma, L., Sanda, G. M., Niculescu, L. S., Deleanu, M., Sima, A. V., & Stancu, C. S. (2020) · Biomolecules · doi:10.3390/biom10040641 · Cited by 87 · see citing works
Rhee, E. (2020) · Endocrinology and Metabolism · doi:10.3803/enm.2020.35.1.85 · Cited by 56 · see citing works
Zhao, W., Wang, L., Haller, V., & Ritsch, A. (2019) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201800887 · Cited by 52 · see citing works
Kober, A. C., Manavalan, A. P. C., Tam‐Amersdorfer, C., Holmér, A., Saeed, A., Fanaee‐Danesh, E., Zandl‐Lang, M., Albrecher, N. M., Björkhem, I., Kostner, G. M., et al. (2017) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2017.03.003 · Cited by 47 · see citing works
Alipov, V. I., Sukhorukov, V. N., Карагодин, В. П., Grechko, A. V., & Orekhov, A. N. (2017) · Vessel Plus · doi:10.20517/2574-1209.2017.20 · Cited by 43 · see citing works
Shen, Y., Shi, L., Nauman, E., Katzmarzyk, P. T., Price‐Haywood, E. G., Bazzano, A. N., Nigam, S., & Hu, G. (2019) · Stroke · doi:10.1161/strokeaha.118.023682 · Cited by 41 · see citing works
Potential Lipid-Lowering Mechanisms of Biochanin A
Xue, Z., Zhang, Q., Yu, W., Wen, H., Hou, X., Li, D., & Kou, X. (2017) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.7b00967 · Cited by 38 · see citing works
Lipids and lipoproteins and inflammatory markers in patients with chronic apical periodontitis
Kimak, A., Strycharz-Dudziak, M., Bachanek, T., & Kimak, E. (2015) · Lipids in Health and Disease · doi:10.1186/s12944-015-0156-5 · Cited by 31 · see citing works
Masson, W. M., Epstein, T., Huerin, M. S., Lobo, M., Molinero, G. B., & Siniawski, D. A. (2019) · Climacteric · doi:10.1080/13697137.2019.1631787 · Cited by 31 · see citing works
Improvement effects of esculetin on the formation and development of atherosclerosis
Wang, Q., Qin, S.-W., & Jiang, J. (2022) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2022.113001 · Cited by 29 · see citing works
Gong, X., Chen, L., Song, B., Han, X., Xu, W., Wu, B., Sheng, F., & Lou, M. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.893248 · Cited by 27 · see citing works
Nakamura, Y., Kabayama, M., Godai, K., Tseng, W., Akasaka, H., Yamamoto, K. I., Takami, Y., Takeya, Y., Gondo, Y., Yasumoto, S., et al. (2023) · Hypertension Research · doi:10.1038/s41440-023-01271-5 · Cited by 27 · see citing works
Hu, X., Li, W., Wang, C., Zhang, H., Lu, H., Li, G., Zhou, Y., & Dong, H. (2021) · Journal of Diabetes Research · doi:10.1155/2021/9238566 · Cited by 24 · see citing works
Farrer, S. (2018) · Advances in Preventive Medicine · doi:10.1155/2018/6024747 · Cited by 21 · see citing works
Barbălată, T., Deleanu, M., Carnuta, M. G., Niculescu, L. S., Răileanu, M., Sima, A. V., & Stancu, C. S. (2019) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201900029 · Cited by 17 · see citing works
Zhang, B., Jin, X., Yin, H., Zhang, D., Zhou, H., Zhang, X., & Tran, L. P. (2020) · Plants · doi:10.3390/plants9050595 · Cited by 17 · see citing works
Barve, K. H. (2019) · Journal of Traditional and Complementary Medicine · doi:10.1016/j.jtcme.2019.11.001 · Cited by 16 · see citing works
Nienov, O. H., Machado, F. D., Dias, L. S., Carli, L. A. D., & Schmid, H. (2019) · Obesity Surgery · doi:10.1007/s11695-019-04126-6 · Cited by 15 · see citing works
ANGPTL3 is a novel HDL component that regulates HDL function
Yang, L., Wang, Y., Xu, Y., Li, K., Yin, R., Zhang, L., Wang, D., Wei, L., Lang, J., Cheng, Y., et al. (2024) · Journal of Translational Medicine · doi:10.1186/s12967-024-05032-x · Cited by 12 · see citing works
Effect of ezetimibe on low- and high-density lipoprotein subclasses in sitosterolemia
Othman, R. A., Myrie, S. B., Mymin, D., Roullet, J., Steiner, R. D., & Jones, P. J. H. (2017) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2017.03.015 · Cited by 12 · see citing works
Kluck, G. E. G., Durham, K. K., Yoo, J., & Trigatti, B. L. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.00065 · Cited by 11 · see citing works
Klinische Bedeutung des HDL-Cholesterins
März, W., Kleber, M. E., Scharnagl, H., Speer, T., Zewinger, S., Ritsch, A., Parhofer, K. G., von Eckardstein, A., Landmesser, U., & Laufs, U. (2016) · Herz · doi:10.1007/s00059-016-4499-0 · Cited by 11 · see citing works
Self-citationMasson, W. M., Lobo, M., Siniawski, D. A., Molinero, G. B., Huerin, M. S., & Nogueira, J. P. (2019) · High Blood Pressure & Cardiovascular Prevention · doi:10.1007/s40292-019-00330-8 · Cited by 10 · see citing works
Sun, L., He, X., Zhang, T., Tao, G., & Wang, X. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.701058 · Cited by 10 · see citing works
Gora, A. H., Rehman, S., Dias, J. P., Fernandes, J. M. O., Olsvik, P. A., Sørensen, M., & Kiron, V. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1161119 · Cited by 9 · see citing works
Hernández, E. (2020) · FARMACIA · doi:10.31925/farmacia.2020.6.19 · Cited by 8 · see citing works
Toward neuroimaging‐based network biomarkers for transient ischemic attack
Lv, Y., Han, X., Song, Y., Han, Y., Zhou, C., Zhou, D., Zhang, F., Xue, Q., Liu, J., Zhao, L., et al. (2019) · Human Brain Mapping · doi:10.1002/hbm.24602 · Cited by 7 · see citing works
Lee, H., Oh, M., Son, H., Park, M., Choi, S. Y., Hur, J., & Park, H. (2025) · Food Science & Nutrition · doi:10.1002/fsn3.70020 · Cited by 6 · see citing works
Radagdam, S., Asoudeh-Fard, A., Karimi, M.-A., Faridvand, Y., Gholinejad, Z., & Nejad, S. G. (2019) · International Journal for Vitamin and Nutrition Research · doi:10.1024/0300-9831/a000613 · Cited by 6 · see citing works
Hetman, M., Mielko, K. A., Płaczkowska, S., Bodetko, A. M., Młynarz, P., & Barg, E. (2023) · Pediatric Endocrinology Diabetes and Metabolism · doi:10.5114/pedm.2023.131162 · Cited by 6 · see citing works
Li, G., Deng, M., He, G., Jiang, Y., Wang, Z., Zhou, C., Xu, W., Feng, T., Zeng, W., Peng, J., et al. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1597820 · Cited by 2 · see citing works
Medical Nutrition Therapy for Lipid and Lipoprotein Disorders
Sapp, P. A., Johnston, E. A., Petersen, K. H., Fleming, J. A., & Kris‐Etherton, P. M. (2020) · Contemporary cardiology · doi:10.1007/978-3-030-56514-5_9 · Cited by 2 · see citing works
Hu, X., Li, W., Wang, C., Zhang, H., Lu, H., Li, G., Zhou, Y., & Dong, H. (2021) · Research Square · doi:10.21203/rs.3.rs-724546/v1 · Cited by 2 · see citing works
Jiang, Y., Deng, M., Song, K., Wang, Z., Xu, W., Feng, T., Chen, S., Wan, C., Ma, X., & Li, F. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1619727 · Cited by 1 · see citing works
Wang, G., Song, G., Wang, L., Gao, F., Guo, N., Zhang, Y., Zhao, N., & Yin, X. (2017) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2017.5149 · Cited by 1 · see citing works
Harnafi, M., Touiss, I., Khatib, S., Bekkouch, O., Rouis, M., Ouguerram, K., Harnafi, H., & Amrani, S. (2019) · Phytothérapie · doi:10.3166/phyto-2019-0207 · Cited by 1 · see citing works
Güzel, K., & İkizek, M. (2021) · Pakistan Journal of Medical Sciences · doi:10.12669/pjms.37.7.4123 · Cited by 1 · see citing works
Parhofer, K. G. (2017) · Der Diabetologe · doi:10.1007/s11428-017-0233-7 · Cited by 1 · see citing works
Self-citationHyperlipidemia and rheumatoid arthritis
Venetsanopoulou, A. I., Voulgari, P. V., & Drosos, A. A. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-85857-1.00003-1 · Cited by 1 · see citing works
Atheroinflammatory Properties of LDL and HDL Particles Modified by Human Mast Cell Neutral Proteases
Maaninka, K. (2018) · Työväentutkimus Vuosikirja
da Rocha, R. E. R., & Otto, M. (2019) · journal of physical education · doi:10.4025/jphyseduc.v30i13064
Introduction to translational research in vascular surgery/medicine
Atturu, G., & Gooneratne, T. (2019) · Indian Journal of Vascular and Endovascular Surgery · doi:10.4103/ijves.ijves_30_19
Live Old Age with Serenity, in Good Health
Ferrara, L. (2020) · Research Journal of Food and Nutrition · doi:10.22259/2637-5583.0403003
Exercício físico moderado e restrição calórica
Gonçalves, R. (2021) · doi:10.47749/t/unicamp.2021.1167780
Schade, D. S., Blankenship, J. C., Adolphe, A., & Eaton, R. P. (2025) · The American Journal of Medicine · doi:10.1016/j.amjmed.2025.11.002
Additional file 1 of ANGPTL3 is a novel HDL component that regulates HDL function
Yang, L., Wang, Y., Xu, Y., Li, K., Yin, R., Zhang, L., Wang, D., Wei, L., Lang, J., Cheng, Y., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26691460
Muluvhu, D. T. C., Hashona, T. S., Toriola, A. L., Paul, Y., & Monyeki, M. A. (2026) · BMC Public Health · doi:10.1186/s12889-026-26565-4
- Authors
- Parhofer, K. G.
- Affiliations
- Ludwig-Maximilians-Universität München (DE)
- Corresponding author
- Parhofer, Klaus G.
- ORCID
- Parhofer, Klaus G.
- Venue
- Atherosclerosis Supplements
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 18
- Pages
- 109-111
- ISSN
- 1567-5688 (ISSN-L)
- OpenAlex
- W2007994695
- Cited by
- 50
- References
- 22
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 7 · 2019: 12 · 2018: 2 · 2017: 8 · 2016: 2 · 2015: 1
- FWCI
- 4.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Atherosclerosis Supplements (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Paraoxonase enzyme and polymorphisms
- Keywords
- HDL cholesterol, atherosclerosis prevention, triglyceride-rich lipoproteins, reverse cholesterol transport, HDL function, LDL cholesterol, dyslipidemia, treatment options
- MeSH terms
- Animals, Hypolipidemic Agents, Humans, Cholesterol, HDL, Risk Factors, Biomarkers, Up-Regulation, Treatment Outcome, Dyslipidemias, Atherosclerosis, Protective Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
