Guideline
Where the HDL hypothesis stands after the CETP trials
Status Editorial position of this site, not a society document
A short statement of what the trial record supports, written so readers are not left inferring a society position that does not exist. No guideline recommends raising HDL cholesterol as a therapeutic goal, and the CETP trials are the main reason.
Three large trials moved HDL-C substantially and changed no outcomes: dal-OUTCOMES, ACCELERATE and, in the sense that its benefit tracked apoB rather than HDL-C, REVEAL. Mendelian randomisation of CETP variants points the same way. The defensible position in 2026 is that HDL-C is a marker, that CETP inhibition should be judged on apoB, and that PREVAIL is the test of whether that judgement is right.
This entry exists because the absence of guidance is itself the answer to a question readers arrive with, and leaving the shelf empty would be less honest than saying so.
Page updated 18 August 2026.