Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention

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Authors: Jesús Millán, Xavier Pintó, Anna Muñoz, et al

Published Date September 2009 Volume 2009:5 Pages 757 - 765

DOI: http://dx.doi.org/10.2147/VHRM.S6269

Jesús Millán¹, Xavier Pintó², Anna Muñoz³, Manuel Zúñiga⁴, Joan Rubiés-Prat⁵, Luis Felipe Pallardo⁶, Luis Masana⁷, Alipio Mangas⁸, Antonio Hernández-Mijares⁹, Pedro González-Santos¹⁰, Juan F Ascaso¹¹, Juan Pedro-Botet¹²

¹Hospital Universitario Gregorio Marañón, Madrid, Spain; ²Hospital Universitario Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain; ³Solvay Pharma, Barcelona, Spain; ⁴Hospital Marqués de Valdecilla, Santander, Spain; ⁵Hospital Vall d’Hebrón, Barcelona, Spain; ⁶Hospital Universitario La Paz, Madrid, Spain; ⁷Hospital Sant Joan, Reus, Tarragona, Spain; ⁸Hospital Universitario Puerta del Mar, Cádiz, Spain; ⁹Hospital Universitario Dr Peset, Valencia, Spain; ¹⁰Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; ¹¹Hospital Clínico Universitario, Valencia, Spain; ¹²Hospital del Mar, Barcelona, Spain

Abstract: Low-density lipoprotein (LDL) cholesterol concentration has been the prime index of cardiovascular disease risk and the main target for therapy. However, several lipoprotein ratios or “atherogenic indices” have been defined in an attempt to optimize the predictive capacity of the lipid profile. In this review, we summarize their pathophysiological aspects, and highlight the rationale for using these lipoprotein ratios as cardiovascular risk factors in clinical practice, specifying their cut-off risk levels and a target for lipid-lowering therapy. Total/high-density lipoprotein (HDL) cholesterol and LDL/HDL cholesterol ratios are risk indicators with greater predictive value than isolated parameters used independently, particularly LDL. Future recommendations regarding the diagnosis and treatment of dyslipidemia, including instruments for calculating cardiovascular risk or action guidelines, should include the lipoprotein ratios with greater predictive power which, in view of the evidence-based results, are none other than those which include HDL cholesterol.

Keywords: apolipoproteins, cholesterol ratios, predictive power, cardiovascular disorders