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Heart disease: The forgotten pandemic

Robert DuBroff1, Maryanne Demasi2

  • 1Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA.

Preventive Medicine
|September 11, 2021
PubMed

Insights

Cholesterol reduction may not prevent heart disease deaths, as coronary heart disease mortality rises despite falling cholesterol levels. Alternative risk factors like insulin resistance may be more critical for cardiovascular health.

Area of Science:

  • Cardiology
  • Metabolic Syndrome
  • Public Health

Background:

  • Coronary heart disease (CHD) remains a leading cause of death.
  • Cholesterol-lowering therapies are widely used for CHD prevention.
  • Recent trends show falling cholesterol levels alongside rising CHD mortality.

Purpose of the Study:

  • To question the efficacy of cholesterol reduction as the primary strategy for preventing coronary heart disease.
  • To explore alternative risk factors for coronary heart disease.
  • To evaluate the effectiveness of cholesterol-lowering interventions.

Main Methods:

  • Review of recent studies on cholesterol and coronary heart disease.
  • Analysis of observational data on statin use and CHD mortality in Europe.
  • Examination of the relationship between cholesterol levels and cardiovascular outcomes.

Main Results:

  • Evidence suggests low-density lipoprotein cholesterol (LDL-C) may not be the primary CHD risk factor.
  • Insulin resistance and remnant cholesterol emerge as potentially more significant markers.
  • Inconsistent results from cholesterol-lowering therapies and lack of CHD decline in Europe despite statin use.

Conclusions:

  • The prevailing strategy of lowering cholesterol for CHD prevention may be flawed.
  • Alternative risk factors require further investigation for effective cardiovascular disease prevention.
  • Re-evaluation of current public health campaigns and therapeutic approaches for heart disease is warranted.

Keywords:
CholesterolHeart diseasePrevention

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