Hypercholesterolemia and inflammation-Cooperative cardiovascular risk factors

Area of Science:

• Cardiovascular Science
• Immunology
• Biochemistry

Background:

• Low plasma low-density lipoprotein cholesterol (LDLc) concentrations reduce LDL particle accumulation in artery walls, slowing atherosclerosis and delaying atherosclerotic plaque development.
• Atherosclerotic plaque development and vulnerability are influenced by both lipid accumulation and inflammation.
• Atherosclerotic cardiovascular disease (ASCVD) risk is significantly reduced by maintaining low LDLc levels over time.

Purpose of the Study:

• To review inflammatory molecular pathways associated with elevated LDLc.
• To describe the effects of lipid-lowering therapies on inflammatory and lipid burden.
• To highlight the interplay between LDLc and inflammation in ASCVD pathogenesis.

Main Methods:

• Narrative review of existing literature.
• Analysis of inflammatory molecular pathways linked to raised LDLc.
• Evaluation of the impact of lipid-lowering approaches on inflammation.

Main Results:

• Immune cell composition changes and altered cytokine/chemokine release disrupt inflammatory balance at plaque sites.
• LDLc and inflammation act synergistically in promoting ASCVD.
• Recent lipid-lowering therapies significantly reduce LDLc, but C-reactive protein reduction may be independent of LDLc magnitude.

Conclusions:

• Identifying clinical inflammation biomarkers, such as interleukin-6, is promising for ASCVD management.
• Targeting inflammatory pathways offers potential for monitoring and reducing ASCVD burden.
• A combined approach addressing both lipid and inflammatory factors is essential for effective ASCVD prevention.