The new study has settled one issue, Barter said. "We saw a residual cardiovascular risk in some people with low LDL levels," he said. "It now appears that the major cause of that risk was low HDL levels. The implication is that we should be treating HDL as well as LDL."
"There is a residual risk, and we think that a substantial proportion of this is mediated by low HDL levels," said Dr. Vera Bittner, a professor of medicine at the University of Alabama at Birmingham and one of the trial leaders. "We all agree that we need drugs that can raise HDL levels, so that we can test the hypothesis that raising HDL will reduce risk."
But Bittner said she was "not quite willing to make the leap of faith that an HDL intervention will work, and the premature discontinuation of the [Pfizer] trial proves my point."
Learn about HDL and LDL cholesterol from the American Heart Association.
SOURCES: Philip Barter, M.D., director, Heart Research Institute, Sydney, Australia; Vera Bittner, professor, medicine, University of Alabama at Birmingham; Sept. 27, 2007, New England Journal of Medicine
All rights reserved