Abstract

The ability of high-density lipoprotein cholesterol to reverse atherosclerosis and reduce cardiovascular disease has been shown in several randomized controlled trials. One mechanism by which high-density lipoprotein cholesterol protects the vascular system includes hemorheology, the study of blood flow. Blood viscosity, or the resistance of flow, can be altered by red blood cell aggregation, red blood cell deformability, and plasma viscosity. Elevated high-density lipoprotein cholesterol levels may improve all of these rheological mediators. An infusion of recombinant high-density lipoprotein cholesterol can immediately release nitric oxide, a potent vasodilator and responder to changes in rheology, into the arteries by activation of endothelial nitric oxide synthase. The stimulation of nitric oxide release by high-density lipoprotein cholesterol may also alter blood rheology. In this article, we will review hemorheology, particularly blood viscosity along with other hemorheological factors, and examine their association with high-density lipoprotein cholesterol.

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