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Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Although not a source of energy, cholesterol plays a significant role as a foundational structure for bile salts, steroid hormones, and vitamin D, as well as being a crucial component of plasma membranes. Approximately 15% of blood cholesterol is derived from our diet, with the remainder synthesized from acetyl CoA by the liver and intestines. Cholesterol is eliminated from the body through its conversion into bile salts, which are eventually discarded in the feces.
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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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LDL cholesterol and atherosclerosis: The evidence.

Carlos Guijarro1, Juan Cosín-Sales2

  • 1Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.

Clinica E Investigacion En Arteriosclerosis : Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
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PubMed
Summary

High LDL cholesterol is a primary cause of atherosclerosis, a major global killer. Recent genetic and clinical studies confirm that lowering LDL cholesterol is essential for preventing cardiovascular disease.

Keywords:
Aleatorización mendelianaAterosclerosisAtherosclerosisClinical trialsColesterol LDLEnsayos clínicosLDL cholesterolLipid theoryMendelian randomizationTeoría lipídica

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Area of Science:

  • Cardiovascular Science
  • Metabolic Disease Research
  • Genetic Epidemiology

Background:

  • Atherosclerosis, a leading cause of global mortality, has long been associated with lipid levels.
  • Despite extensive evidence, the role of hypercholesterolemia in atherosclerosis development has faced recent scrutiny.
  • Atherosclerotic cardiovascular disease (ASCVD) remains a critical public health concern worldwide.

Purpose of the Study:

  • To review recent genetic and clinical evidence on the role of LDL cholesterol in atherosclerosis.
  • To reaffirm the etiological significance of LDL cholesterol in atherosclerotic development.
  • To emphasize the importance of LDL cholesterol lowering in managing cardiovascular complications.

Main Methods:

  • Review of recent Mendelian randomization genetic studies.
  • Analysis of randomized clinical trials focused on LDL cholesterol reduction.
  • Synthesis of experimental, epidemiological, and clinical evidence.

Main Results:

  • Recent genetic studies unequivocally support the causal role of LDL cholesterol in atherosclerosis.
  • Randomized clinical trials demonstrate significant cardiovascular risk reduction with LDL cholesterol lowering.
  • Evidence consistently validates the lipid theory of atherosclerosis.

Conclusions:

  • LDL cholesterol is definitively established as a key etiological factor in atherosclerosis.
  • Lowering LDL cholesterol is the cornerstone of effective lipid-lowering therapy for ASCVD.
  • Therapeutic strategies targeting LDL cholesterol are crucial for reducing atherosclerotic cardiovascular complications.