[Therapy of Hypercholesterolemia in Primary Prevention]

Area of Science:

• Cardiology
• Preventive Medicine
• Clinical Lipidology

Background:

• Atherosclerotic cardiovascular disease (ASCVD) is a major global health burden.
• Dyslipidemia, particularly elevated low-density lipoprotein-cholesterol (LDL-C), is a key driver of ASCVD.
• Establishing causality of LDL-C in ASCVD pathophysiology is critical for prevention.

Purpose of the Study:

• To review current evidence on LDL-C lowering for cardiovascular disease primary prevention.
• To discuss guideline recommendations and clinical strategies for managing LDL-C in primary prevention.
• To address controversies regarding patient selection, benefit magnitude, and potential harm in primary prevention.

Main Methods:

• Literature review of current evidence and guideline recommendations.
• Analysis of strategies for lowering LDL-C.
• Discussion of controversies in primary prevention.

Main Results:

• Statins are first-line for secondary prevention of hypercholesterolemia.
• Evidence for primary prevention requires careful consideration of individual risk, benefit, and harm.
• Optimal LDL-C targets and treatment thresholds remain subjects of ongoing debate.

Conclusions:

• Lowering LDL-C is crucial for preventing cardiovascular events.
• Personalized risk assessment is essential for guiding primary prevention strategies.
• Further research is needed to refine guidelines for LDL-C management in primary prevention.