High density lipoprotein cholesterol and statin trials.

Epidemiological studies show that high density lipoprotein cholesterol (HDL-C) levels are inversely related to the risk of vascular events. Statins are the most widely prescribed drugs for the treatment of dyslipidaemias and their use for the prevention of vascular events is evidence based. Statins raise HDL-C but this effect seems to vary considerably between studies. We searched the literature to assess the relationship between statin-induced increases in HDL-C levels and surrogate and/or clinical endpoints. Based on the existing evidence, it is difficult to determine how much reduction, if any, in vascular risk is attributable to a statin-induced increment in HDL-C levels. Whether a statin that beyond its LDL-C lowering effect also raises HDL-C has additional benefits in the prevention of vascular events remains to be established.