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Cholesterol Lowering Therapy: Treat to Target or Reduce the Global Risk? The Unresolved Problem of Residual Risk

Giulia Bruzzone, Giorgia Corbelli, Paola Belci

  • 1Department of Internal Medicine University of Genoa Viale Benedetto XV 6 16132 Genoa, Italy.

Current Pharmaceutical Design
|August 24, 2016
PubMed

Insights

Residual risk in Atherosclerotic Cardiovascular Disease (ASCVD) persists despite statin therapy. Factors like dyslipidemia, genetics, and lifestyle contribute to this risk, necessitating further research for improved cardiovascular disease prevention.

Area of Science:

  • Cardiology
  • Genetics
  • Public Health

Background:

  • Atherosclerotic Cardiovascular Disease (ASCVD) is a leading cause of mortality in Western countries.
  • Statin therapy reduces ASCVD mortality but a significant residual risk remains even at low-density lipoprotein cholesterol (LDL-C) goals.

Purpose of the Study:

  • To review literature on residual dyslipidemia, genetic factors, lifestyle, and mood disorders contributing to residual cardiovascular risk.
  • To discuss the current understanding and contradictory aspects of these factors in ASCVD.

Main Methods:

  • Literature review of studies published in PubMed.
  • Focus on high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), lipoprotein(a) [Lp(a)], genetic factors, and lifestyle implementation.

Main Results:

  • The classical HDL hypothesis is outdated; HDL function is now considered more critical.
  • The relationship between TGs and cardiovascular risk is not definitive.
  • APOE genotype and Lp(a) levels are identified genetic risk factors.

Conclusions:

  • HDL function requires further validation.
  • Lifestyle and psychological factors play a crucial role in managing global cardiovascular risk.
  • Addressing residual risk factors beyond LDL-C is essential for ASCVD prevention.
Abstract

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