High density lipoproteins (HDL) are responsible for the reverse transport ofcholesterol from the peripheral cells to the liver. Here, cholesterol istransformed to bile acids which are excreted into the intestine via the biliarytract.
Approximately 25% of total serum cholesterol is transported in the HDL fraction.
Numerous clinical and epidemiologicalstudies have demonstrated a strong inverse association between HDL-cholesterol and the incidence of coronary heartdisease. It has been proposed that the uptake and transport of cholesterol from peripheral tissue to the liver acts asa protective factor against the development of atherosclerotic plaques. Determination of HDL-cholesterol is thereforeessential for the interpretation of individual cholesterol determinations.
Low HDL-cholesterol is a risk factor independentof total cholesterol concentration and is highly predictive of the risk of coronary heart disease. Measurement ofHDL-cholesterol is used in the early recognition of atherosclerosis risk, and may also be used in the monitoring ofindividuals during treatment with lipid lowering drugs.
Strategies have emerged to increase the level of HDL‐cholesterol to treatcardiovascular disease.
National Cholesterol Education Program (NCEP) guidelines < 1.03 mmol/L (< 40 mg/dL) Low HDL-cholesterol (major risk factor for coronary heart disease) ≥ 1.55 mmol/L (≥ 60 mg/dL) High HDL-cholesterol (“negative” risk factor for coronary heart disease)