HDL and ASCVD: is high HDL-C protective, harmful, or simply misleading?

Key Points

• Examine the role of HDL-C as a marker for atheroprotection and its implications for cardiovascular disease risk.
• Literature review on HDL biology and its implications for ASCVD risk
• Discussion on the limitations of HDL-C as a sole indicator of health
• Recommendations for prioritizing functional HDL metrics and mechanism-focused trials.
• High HDL-C levels alone may not indicate reduced risk of ASCVD
• Emphasis on the need for functional metrics of HDL quality
• Current understanding of HDL-C requires reevaluation for therapeutic approaches.

Abstract