New metrics needed to visualize the long-term impact of early LDL-C lowering on the cardiovascular disease trajectory

Area of Science:

• Cardiovascular Medicine
• Preventive Cardiology
• Public Health

Background:

• Short-term cardiovascular event risk is low in young/middle-aged individuals, even with risk factors.
• Current metrics like number-needed-to-treat over 5 years inadequately convey lifelong benefits of interventions.
• Effective communication of long-term benefits of therapies like statins is challenging.

Purpose of the Study:

• To highlight the inadequacy of short-term metrics in cardiovascular risk assessment.
• To emphasize the need for lifelong perspectives in evaluating interventions.
• To advocate for new metrics and approaches for primordial prevention of atherosclerosis.

Main Methods:

• Review of current cardiovascular risk assessment parameters.
• Analysis of the limitations of short-term outcome measures.
• Conceptual framework for lifelong disease trajectory and prevention.

Main Results:

• Short-term event rates do not adequately represent lifelong risk or intervention benefits.
• Existing metrics fail to capture the cumulative impact of risk factors and interventions over a lifetime.
• A paradigm shift towards lifelong disease trajectory is needed.

Conclusions:

• Focusing on lifelong disease trajectories is essential for effective cardiovascular risk management.
• Development of novel metrics is required to communicate lifelong benefits of interventions.
• Primordial prevention of atherosclerosis necessitates new physician-patient interaction models and tools.