Is lowering low-density lipoprotein an effective strategy to reduce cardiac risk? Lipid Management to Reduce Cardiovascular Risk: A New Strategy Is Required

摘要

For the past 22 years substantial national efforts have been directed toward reducing the average blood low-density lipoprotein cholesterol (LDL-C) level of the American population. This initiative was initially prompted by the success-ful results of the Lipid Research Clinic-Coronary Primary Prevention Trial (LRC-CPPT), which first proved that reducing LDL-C resulted in a statistically significant reduction in cardiovascular events. The intent of these efforts has been to reduce the human suffering and economic cost of cardiovascular disease. In the subsequent 2 decades, a plethora of monotherapy cholesterol-lowering drug trials has consistently reported a statistically significant 25% relative risk reduction for cardiovascular events. These findings form the basis for the current Adult Treatment Panel (ATP) III guidelines and the recent call to adjust the LDL-C goal even lower.