Lipoproteínas clásicas, terapéuticas modernas. Farmacología de las lipoproteínas de alta densidad

Several clinical trials with high-dose statins have reported optimal low-density lipoprotein cholesterol (LDL-C) concentrations. However the incidence of cardiovascular episodes in these clinical trials continues to be high. Interventions designed to act on other risk factors such as highdensity lipoprotein cholesterol (HDL-C) can minimize these episodes in subjects with normal LDL-C levels. Few studies have been performed with drugs that increase HDL-C and their results are less consistent than those that achieve a reduction of LDL-C, indicating the complex metabolism of HDL and that modification of HDL-C concentrations is not objective but rather improves its antiatherogenic functions, which include reverse cholesterol transport and its antioxidant and antiinflammatory capacity. New drugs with peroxisome proliferator activated receptors (PPAR) alpha and/or gamma activity, cholesteryl ester transfer protein (CETP) inhibitors, cannabinoid receptor inhibitors, recombinant apolipoprotein A-I, LXR and FXR agonists have strong clinical potential to improve not only the concentration but also the impaired functions associated with low HDL-C.