The hope is that a drug that modifies LDL and HDL in favorable directions will actually reduce patient risk and improve outcomes.

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However, concerns over its impact on LDL and HDL (as well as anemia, neutrophil suppression, and liver enzymes elevations) lingered and questions regarding whether these laboratory measures would translate into clinical events were raised.

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The Cornell group had an average LDL of 150 and HDL of 37.

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The impact of the little HDL increase appears as important as that of the big LDL decrease.

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The mutation carriers had less artery calcification, indicating that they had healthier hearts as well as higher HDL (good cholesterol), and lower triglycerides and LDL (bad cholesterol).

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Both work by inhibiting an obscure molecule called the cholesterol ester transfer protein (CETP) that works indirectly to prevent HDL from being used to create low-density lipoprotein (LDL), the bad cholesterol.

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In December 2012, the FDA approved Juxtapid (lomitapide) to reduce LDL-C, total cholesterol, apolipoprotein B, and non HDL-C in patients with HoFH.

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Big studies have shown that low HDL levels may be as important as high levels of low-density lipoprotein (LDL) in causing heart attacks.

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While the shrimp diet did increase people's so-called bad cholesterol or LDL slightly, it also boosted their so-called good cholesterol or HDL enough to offset the increase in bad cholesterol.

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Not only has Griola lost about 90 pounds in five years, but her HDL has gone from 47 (in the unhealthy range) to 56, her LDL has dropped from 109 to 94, and her triglycerides (a fat associated with heart disease) have plummeted from 130 to a very healthy 56.

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Another Zetia benefit: In studies, some patients not only saw "bad" LDL cholesterol decrease, they also saw a slight increase in "good" HDL cholesterol, which is thought to be better for health.

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"The system is set up so that the HDL high density lipoproteins, or artery-cleaning or 'good' cholesterol, cleans out the LDL low density lipoproteins, or 'bad' cholesterol, " she explains.

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Low-density lipoprotein (LDL) or bad cholesterol levels should be below 100, and high-density lipoprotein (HDL) should measure 35 or above.

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Whereas LDL brings cholesterol to the artery wall, where it collects in heart attack-causing plaques, HDL carts it away.

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While Esperion is working on an HDL-boosting treatment, "we're focusing most of our energies and finances" on a new LDL-lowering medicine, he says.

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