Future in lipid and lipoprotein research: from preventing clinical disease to preventing elevated risk factors

The decline in cardiovascular disease has been a major public health success. The relationship between key risk factors such as blood cholesterol levels, smoking, high blood pressure and clinical disease are universally accepted. The approaches to the prevention of cardiovascular disease are changing to a greater emphasis on the prevention of elevated risk factors by better understanding of the relationship between lifestyle and host susceptibility (genetic attributes) and the risk factor changes with age. The development of new methods to measure vascular disease non-invasively in vivo changes the approaches to evaluation of both risk and definition of endpoints in analytical studies and clinical trials. It is possible now to increase the rate of decline in coronary heart disease.