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Lipid parameters for measuring risk of cardiovascular disease

Benoit J Arsenault1, S Matthijs Boekholdt, John J P Kastelein

  • 1Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

Nature Reviews. Cardiology
|February 2, 2011
PubMed

Insights

Assessing the lipid spectrum beyond LDL-cholesterol, including non-HDL cholesterol and apolipoprotein B, is crucial for identifying cardiovascular disease risk. Other lipid markers like HDL cholesterol and apo A-I also predict risk, especially with physical inactivity and obesity.

Area of Science:

  • Cardiology
  • Lipidology
  • Preventive Medicine

Background:

  • Lipid spectrum assessment is vital for cardiovascular disease (CVD) risk stratification and guiding lipid-lowering therapy.
  • While LDL-cholesterol is a primary target, other lipoprotein-lipid measurements offer additional predictive value.

Purpose of the Study:

  • To review the measurement of lipoprotein-lipid parameters for CVD risk prediction.
  • To highlight the importance of these markers in identifying patients for lipid-lowering therapy.
  • To consider the impact of recent studies on clinical guidelines.

Main Methods:

  • Review of current literature on lipid spectrum analysis and CVD risk.
  • Analysis of the predictive value of various lipoprotein-lipid measurements beyond LDL-cholesterol.
  • Examination of the influence of physical inactivity and abdominal obesity on residual cardiovascular risk.

Main Results:

  • High non-HDL cholesterol or apolipoprotein B levels indicate increased CVD risk despite low LDL-cholesterol.
  • Low HDL cholesterol or apo A-I levels are associated with cardiovascular events, even with normal LDL-cholesterol.
  • Residual CVD risk is exacerbated by physical inactivity and abdominal obesity.

Conclusions:

  • Lipoprotein-lipid measurements beyond LDL-cholesterol are essential for comprehensive CVD risk assessment.
  • These advanced lipid markers help identify individuals who may benefit from intensified lipid-lowering strategies.
  • Clinical guidelines should incorporate these findings for improved patient outcomes.

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