Coronary prevention and regression studies updated

There have been a multitude of clinical, animal and epidemiology studies which prove that high serum cholesterol and low density lipoprotein (LDL) cholesterol concentrations are specific causes of coronary artery disease (CAD). Although the variations in experimental design make comparisons difficult, the aggregate results of many human prevention trials since 1960 lead to the definite conclusion that a 10% lowering of serum cholesterol reduces the risk of CAD by one-sixth. Recently, other factors for CAD risk have been identified that will be useful in guiding treatment, namely serum high density lipoprotein (HDL) cholesterol, apolipoproteins B and AI, HDL triglycerides and phosphatidylcholine to free cholesterol ratio. Studies have shown that aggressive drug and diet therapy slows progression and causes regression of atheromas. Primary prevention of CAD is obviously preferable to secondary prevention. Also, the evidence to date indicates that prevention of CAD through lifestyle changes should begin in childhood.