Targeting low high-density lipoprotein cholesterol for therapy: lessons from the Veterans Affairs High-density Lipoprotein Intervention Trial

Am J Cardiol. 2001 Dec 20;88(12A):19N-23N. doi: 10.1016/s0002-9149(01)02148-8.


Results of the Veterans Affairs High-Density Lipoprotein Intervention Trial (VA-HIT) showed that therapy with the fibric acid gemfibrozil significantly reduced the incidence of coronary artery disease events in men with known coronary artery disease and a low level of high-density lipoprotein cholesterol (HDL-C). Coronary artery disease event reduction was inversely related to levels of HDL-C achieved with gemfibrozil and, even at relatively low concentrations of HDL-C, coronary artery disease event reduction with gemfibrozil was significantly greater than with placebo. Subjects with a low HDL-C level who were recruited for VA-HIT had a high prevalence of features of the metabolic syndrome with obesity, type 2 diabetes, and hyperinsulinemia. These individuals especially benefited from gemfibrozil, and thus, fibrate therapy may have an increasing role in reducing coronary artery disease risk in a setting of an increasing worldwide prevalence of obesity and diabetes.

Publication types

  • Review

MeSH terms

  • Cholesterol, HDL / blood*
  • Cholesterol, HDL / drug effects
  • Coronary Disease / etiology
  • Coronary Disease / prevention & control*
  • Gemfibrozil / therapeutic use*
  • Humans
  • Hypolipidemic Agents / therapeutic use*
  • Hypolipoproteinemias / complications
  • Hypolipoproteinemias / drug therapy*
  • Male
  • Randomized Controlled Trials as Topic
  • Risk


  • Cholesterol, HDL
  • Hypolipidemic Agents
  • Gemfibrozil