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Relationship between LDL, HDL, blood pressure and atheroma progression in the coronaries

Stephen J Nicholls1

  • 1Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. nichols1@ccf.org

Current Opinion in Lipidology
|July 14, 2009
PubMed

Insights

Coronary artery imaging trials show intensive risk factor modification significantly impacts atherosclerosis progression. Aggressively lowering LDL cholesterol and blood pressure offers the greatest benefit in slowing coronary artery disease.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Pharmacology

Background:

  • Coronary artery disease (CAD) remains a leading cause of mortality worldwide.
  • Effective management strategies focus on modifying established cardiovascular risk factors.
  • Coronary artery imaging provides detailed insights into atherosclerotic plaque burden and composition.

Purpose of the Study:

  • To review clinical trials utilizing coronary artery imaging.
  • To evaluate the effects of medical therapies targeting cardiovascular risk factors on atherosclerosis.
  • To assess the impact of these therapies on disease progression and plaque characteristics.

Main Methods:

  • Analysis of clinical trials employing high-resolution coronary artery imaging techniques.
  • Assessment of imaging data to quantify changes in vessel wall and atherosclerotic plaque.
  • Correlation of imaging findings with therapeutic interventions aimed at risk factor modification.

Main Results:

  • High-resolution imaging allows comprehensive assessment of the entire vessel wall and atherosclerotic extent.
  • Intensive reduction of low-density lipoprotein (LDL) cholesterol and systolic blood pressure demonstrated significant slowing of disease progression.
  • Therapies enhancing high-density lipoprotein (HDL) activity and targeting inflammatory pathways show potential for plaque regression and improved plaque composition.

Conclusions:

  • Intensive modification of established cardiovascular risk factors profoundly influences the natural history of atheroma progression.
  • Coronary artery imaging is a valuable tool for evaluating therapeutic efficacy in managing atherosclerosis.
Abstract

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