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Curr Atheroscler Rep. 2013 Apr;15(4):312. doi: 10.1007/s11883-013-0312-1.

The role of early LDL lowering to prevent the onset of atherosclerotic disease.

Author information

1
Division of Translational Research and Clinical Epidemiology (TRaCE), Wayne State University School of Medicine, UHC, 4H-34, Detroit, MI 48201, USA. bference@med.wayne.edu

Abstract

Coronary atherosclerosis is a chronic progressive disease that begins early in life and progresses slowly over several decades before becoming clinically manifest. The causal relationship between low-density lipoprotein cholesterol (LDL-C) and the risk of coronary atherosclerosis is well established. Multiple randomized trials have demonstrated that lowering LDL-C levels during treatment with a statin reduces the risk of major atherosclerotic coronary events. However, individuals being treated with a statin continue to experience a high residual risk of events. Here we review the evidence that lowering LDL-C levels beginning earlier in life, and therefore earlier in the atherosclerotic disease process, can prevent or substantially delay the development of atherosclerosis and thereby substantially improve the clinical benefit of therapies that lower LDL-C levels. We focus on providing a critical appraisal of the naturally randomized evidence that is emerging from recently conducted genetic association studies.

PMID:
23423521
DOI:
10.1007/s11883-013-0312-1
[Indexed for MEDLINE]

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