A large genetic study in Chinese adults showed no benefit of raising “good” cholesterol by CETP inhibition

Nov 15, 2017 4:00 PM

Raising so-called “good” cholesterol by blocking a key protein involved in its metabolism does not protect against heart disease or stroke, according to a large genetic study of 150,000 Chinese adults published this week in JAMA Cardiology.

Researchers at the University of Oxford, Peking University and Chinese Academy of Medical Sciences explored the health effects of CETP genetic variants, including an East Asian specific functional variant, in 150,000 Chinese adults enrolled into the China Kadoorie Biobank (CKB). After ten years of follow-up, over 5,000 study participants had coronary heart disease and 19,000 had a stroke. The researchers found that CETP genetic variants raised levels of HDL-C substantially, but did not lower LDL-C and did not lower the risk of cardiovascular diseases such as heart disease and stroke. There was also no effect on atherosclerotic plaques and thickness of the arteries, or on other conditions such as diabetes and kidney disease. However, the study found increased risk of eye diseases as a possible adverse effect of CETP inhibition, a finding which is supported by other genetic studies in East Asian and Western populations.

In this study of genetic variants which alter CETP activity, raising HDL-C without also lowering LDL-C did not result in a benefit for heart disease or stroke. The study results complement findings from the recent REVEAL clinical trial of the CETP inhibitor anacetrapib, which found that beneficial effects of CETP inhibition for heart disease were more likely to be due to lowering “bad” cholesterol LDL-C than raising “good” HDL-C.2

Read the full paper here.