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J Am Coll Cardiol. 2018 Sep 4;72(10):1141-1156. doi: 10.1016/j.jacc.2018.06.046.

Impact of Lipids on Cardiovascular Health: JACC Health Promotion Series.

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Centre for Naturally Randomized Trials, University of Cambridge, Cambridge, United Kingdom.
School of Medicine, Trinity College, Dublin, Ireland.
Department of Cardiology, Hacettepe University, Ankara, Turkey.
Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy; IRCCS Multimedica, Milan, Italy. Electronic address:


People who maintain ideal cardiovascular heath have a low lifetime risk of cardiovascular disease. Therefore, encouraging people to achieve ideal cardiovascular health represents an important opportunity to improve the prevention of cardiovascular disease. However, preventing cardiovascular disease by promoting ideal cardiovascular health requires shifting the focus from treating disease after it develops to preventing cardiovascular events before they happen by slowing the progression of atherosclerosis. Because atherogenic lipoproteins play a central causal role in the initiation and progression of atherosclerosis, maintaining optimal lipid levels is necessary to achieve ideal cardiovascular health. This review describes the cumulative effect of lipid-carrying lipoproteins on the risk of cardiovascular disease, estimates the magnitude of the clinical benefit that can be achieved by maintaining optimal lipid levels, identifies the most effective timing for implementing strategies designed to achieve optimal lipid levels, and provides a clinical pathway to help people achieve the lipid levels necessary for ideal cardiovascular health.


apolipoproteins; cholesterol; low-density lipoproteins; population; risk; total burden

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