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Published on: November 17, 2018
Low-density lipoprotein cholesterol: how low can we go?
Daniel P Sherbet1, Puja Garg, Emmanouil S Brilakis
1University of Texas Southwestern Medical Center, Dallas, TX, USA.
Lowering low-density lipoprotein cholesterol (LDL-C) significantly reduces cardiovascular disease risk. Further LDL-C reductions beyond current targets, using statins and novel therapies, may offer additional safety and efficacy benefits.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Elevated low-density lipoprotein cholesterol (LDL-C) is a primary driver of cardiovascular disease (CVD) and related adverse events.
- Established evidence confirms that lowering plasma LDL-C effectively reduces coronary heart disease (CHD) risk and secondary event rates.
Purpose of the Study:
- To review intensive LDL-C lowering strategies, particularly with statins.
- To evaluate the potential for achieving lower plasma LDL-C thresholds for enhanced safety and efficacy.
- To explore methods for attaining very low LDL-C levels.
Main Methods:
- Review of current literature on intensive LDL-C lowering therapies.
- Analysis of data regarding the safety and efficacy of statin therapy.
- Discussion of traditional and novel therapeutic approaches for LDL-C reduction.
Main Results:
- Current guidelines recommend specific LDL-C targets, but optimal lower thresholds remain undefined.
- Intensive LDL-C lowering with statins demonstrates significant cardiovascular benefits.
- Further reductions in LDL-C beyond current targets are proposed to be safe and effective.
Conclusions:
- Achieving very low plasma LDL-C levels is likely to further reduce cardiovascular event rates.
- Both traditional and novel LDL-lowering therapies can be employed to reach these lower thresholds.
- Continued research into optimal LDL-C targets and therapeutic strategies is warranted.
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