Aggressive Treatment of High-Density Lipoprotein Cholesterol
Authors: Richard A. Krasuski
Journal: Annals of Internal Medicine (2005)

Letters21 June 2005Aggressive Treatment of High-Density Lipoprotein CholesterolRichard A. Krasuski, MD and Edwin J. Whitney, MDRichard A. Krasuski, MDFrom the Wilford Hall Medical Center and Heart and Vascular Institute of Texas, San Antonio, TX 78217Search for more papers by this author and Edwin J. Whitney, MDFrom the Wilford Hall Medical Center and Heart and Vascular Institute of Texas, San Antonio, TX 78217Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-12_Part_1-200506210-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Nicholls's comments and agree that the agents studied in the Armed Forces Regression Study (AFREGS), particularly niacin, have not traditionally been well tolerated. With newer formulations of niacin and proper patient instruction, adherence has been much improved (1). Until newer agents have undergone more rigorous study and review, niacin remains the single most effective agent to increase HDL cholesterol level. Whether its well-established clinical benefits are derived from changes in quantity or quality of HDL or low-density lipoprotein cholesterol remains controversial, and unfortunately lipoprotein subtyping was not performed in the AFREGS population.Although fibrinogen levels ...References1. Knopp RH. Evaluating niacin in its various forms. Am J Cardiol. 2000;86:51L-56L. [PMID: 11374857] CrossrefMedlineGoogle Scholar2. Schoenhagen P, Nissen SE. Coronary atherosclerotic disease burden: an emerging endpoint in progression/regression studies using intravascular ultrasound. Curr Drug Targets Cardiovasc Haematol Disord. 2003;3:218-26. [PMID: 12871040] CrossrefMedlineGoogle Scholar3. Thompson GR. Angiographic trials of lipid-lowering therapy: end of an era? Br Heart J. 1995;74:343-7. [PMID: 7488443] CrossrefMedlineGoogle Scholar4. Nissen SE, Tuzcu EM, Schoenhagen P, Brown BG, Ganz P, Vogel RA, et al. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized, controlled trial. JAMA. 2004;291:1071-80. [PMID: 14996776] CrossrefMedlineGoogle Scholar5. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143-421. [PMID: 12485966] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Richard A. Krasuski, MD; Edwin J. Whitney, MDAffiliations: From the Wilford Hall Medical Center and Heart and Vascular Institute of Texas, San Antonio, TX 78217Disclosures: Consultancies, honoraria, and grants received: R.A. Krasuski (Pfizer Pharmaceuticals). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Randomized Trial of a Strategy for Increasing High-Density Lipoprotein Cholesterol Levels: Effects on Progression of Coronary Heart Disease and Clinical Events Edwin J. Whitney , Richard A. Krasuski , Bradley E. Personius , Joel E. Michalek , Ara M. Maranian , Mark W. Kolasa , Erik Monick , B. Gregory Brown , and Antonio M. Gotto Jr. Aggressive Treatment of High-Density Lipoprotein Cholesterol Stephen J. Nicholls Aggressive Treatment of High-Density Lipoprotein Cholesterol Stephen J. Nicholls Metrics 21 June 2005Volume 142, Issue 12_Part_1Page: 1025-1026KeywordsAngiographyAtherosclerosisCholesterolFibrinogenInflammationMyocardial infarctionNiacinStatinsUltrasound imaging ePublished: 21 June 2005 Issue Published: 21 June 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...