Enhancing reverse cholesterol transport/raising HDL cholesterol: new options for prevention and treatment of cardiovascular disease.

High-density lipoprotein cholesterol (HDL-c) plays a crucial role in the concept of reverse cholesterol transport and has many other beneficial properties which may interfere with atherogenesis and plaque rupture. Low HDL-c levels are currently considered to be an important risk factor for the development of cardiovascular disease. However until recently no effective and safe treatment for powerfully increasing HDL-c selectively was available. This short overview describes possible new therapeutic approaches that may be able to raise HDL-c levels or improve HDL-c metabolism/reverse cholesterol transport. Today, the most important targets to be evaluated are inhibition of cholesteryl ester transfer protein (CETP) and increasing the HDL-c level by infusion of engineered HDL particles. Trials to prove clinical benefit of new HDL-c raising approaches are underway and may well be a new starting point for an optimised prevention and treatment of atherosclerotic cardiovascular disease.