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Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein
Published on: October 12, 2017
[Role of LDL in cardiovascular diseases. New data and new recommendations]
1Unité d'exploration métabolique pour la prévention des maladies cardiovasculaires, Hôpital Pitié-Salpêtrière, Paris (75), France.
Insights
Aggressively lowering LDL-cholesterol with statins and new therapies reduces cardiovascular risk. Therapeutic education and new HDL treatments are key for clinical practice success and patient compliance.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Context:
- Hypercholesterolemia management has evolved significantly, driven by large-scale clinical trials.
- Statins have proven effective in reducing cardiovascular morbidity and mortality by targeting LDL-cholesterol.
- Recent research supports an aggressive cholesterol-lowering strategy, even in patients with lower baseline levels.
Purpose:
- To review the progress in hypercholesterolemia management, focusing on LDL-cholesterol reduction strategies.
- To discuss the challenges in translating aggressive lipid-lowering strategies into clinical practice.
- To highlight the role of therapeutic education and emerging HDL-focused treatments.
Summary:
- Extensive clinical trials demonstrate statin efficacy in lowering LDL-cholesterol, reducing cardiovascular events and mortality.
- Newer, potent statins and combination therapies enhance the ability to achieve very low cholesterol levels.
- Clinical implementation faces barriers including patient/practitioner hesitancy, compliance issues, and cost concerns.
Impact:
- Aggressive LDL-cholesterol reduction strategies, supported by advanced therapies, offer improved cardiovascular prevention.
- Therapeutic education is crucial for enhancing patient compliance with lipid-lowering treatments.
- Future advancements in HDL-targeting therapies may further enhance cardiovascular disease prevention.
Abstract:
The management of hypercholesterolemia has rapidly progressed with the large clinical trials mainly on statins. Over the past 15 years, it has been demonstrated that the principle target was LDL-cholesterol and that treatment with statins decreased cardiovascular morbidity and global mortality. The studies have progressively targeted patients with increasingly lower cholesterol levels but always at high risk. Recent data are in favour of the so-called "aggressive" strategy aimed at reducing cholesterol to very low levels. The emergence of new therapies with stronger statins and the concept of combining lipid-lowering treatments has improved the chances of reaching this aim. Prompted by this progress, the transposition of this aggressive strategy to clinical practice is confronted with many problems, which stem from practitioners' and patients' reticence and fears (raising the question of compliance to treatment) and, more generally, the problem of cost. In this perspective, therapeutic education is one of the tools that would promote compliance. New treatments in the field of HDL would further support the progress made in such prevention.
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