Gemfibrozil prevents major coronary events by increasing HDL-cholesterol and more.

A low concentration of plasma high-density lipoprotein (HDL)-cholesterol is a major risk factor for coronary heart disease (CHD). Gemfibrozil reduces the number of CHD events by 22% in 5 years. This marked beneficial effect can only partly be explained by the ability of gemfibrozil to increase HDL-cholesterol. Recently gemfibrozil has been shown to activate peroxisome proliferator-activated nuclear receptors. This activation leads to the increase in HDL-cholesterol and to a decrease in vascular wall inflammation and other changes in vascular function. These vascular effects of gemfibrozil may contribute to the beneficial effects in CHD.