Research now going beyond reaching low LDL cholesterol

Studies are under way to test drugs that use different mechanisms to raise levels of HDL cholesterol.

By Susan J. Landers, AMNews staff. Aug. 1, 2005.

Washington -- As the quest continues for earlier identification of people at risk for heart disease, taking a closer look for possible triggers in the bloodstream is emerging as a key element.

Studies have consistently shown that lower numbers are better for low-density lipoprotein cholesterol, and researchers suspect that higher numbers are better for high-density lipoprotein cholesterol.

Thus, three large studies are under way to test different mechanisms for raising good cholesterol and to determine whether higher levels of HDL do in fact reduce the risk of heart attack and stroke.

"Clearly, HDL has become the new frontier, said William Boden, MD, director of cardiology at Hartford (Conn.) Hospital and a lead investigator in one of the new studies.

No one is disputing that low levels of LDL cholesterol are good. That has been the primary focus of heart disease prevention for decades. But intriguing findings have also pointed to high levels of HDL cholesterol as being part of a beneficial lipid profile, and researchers are out to prove this. "Clearly, everybody is now getting on the bandwagon," Dr. Boden said.

Dr. Boden is co-investigator of a six-year study funded by the National Heart, Lung, and Blood Institute to evaluate whether a combination of an extended-release version of niacin, marketed as Niaspan, plus simvastatin is better able to prevent heart disease than is simvastatin alone.

Kos Pharmaceuticals, the manufacturer of Niaspan, is also contributing funds to the trial.