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Updated: Aug 27, 2026
Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein
Published on: October 12, 2017
[Hypolipemic agents and prevention of coronary disease]
R Chadarevian1, E Bruckert, G Turpin
1Service d'Endocrinologie-Métabolisme, Hôpital Pitté-Salpĕtrière, Paris.
Insights
High cholesterol (hypercholesterolemia) increases coronary heart disease risk. Lipid-lowering therapies, including statins, effectively reduce cardiovascular events, especially for high-risk patients.
Area of Science:
- Cardiology
- Metabolic Disorders
Context:
- Hypercholesterolemia, specifically elevated LDL-cholesterol, is a significant risk factor for coronary heart disease (CHD).
- Lipid-lowering therapies demonstrate efficacy in reducing cardiovascular morbidity and mortality in both primary and secondary prevention settings.
Purpose:
- To review the established role of lipid-lowering therapies in managing hypercholesterolemia and preventing cardiovascular disease.
- To discuss the application and limitations of clinical trial data in general practice and outline treatment strategies.
Summary:
- Clinical trials consistently show that lipid-lowering treatments reduce cardiovascular events, with benefits observed per 1000 patients treated.
- While trials often focus on high-risk populations, subgroup analyses indicate benefits are independent of age and baseline lipid levels within the studied ranges.
- Dietary modifications are foundational and should complement pharmacologic interventions. Statins are primary treatments for type IIa hypercholesterolemia, targeting LDL-cholesterol below 1.30 g/l in CHD patients. Fibrates offer alternatives for hypertriglyceridemia, low HDL-cholesterol, or statin intolerance.
Impact:
- Emphasizes the importance of personalized lipid management based on precise lipid patterns.
- Highlights the need for cautious extrapolation of trial data to diverse patient populations in general practice.
- Provides guidance on the selection of lipid-lowering agents (statins, fibrates) based on specific lipid profiles and patient characteristics.
Abstract:
Hypercholesterolemia, particularly high levels of LDL-cholesterol, is a well established risk factor for coronary heart disease. Lipid-lowering therapies are associated with a reduction in cardiovascular morbidity and mortality in secondary as well as primary prevention. These trials are consistent with epidemiological studies and emphasize the importance of the benefit in terms of the number of cardiovascular events avoided per 1000 patients treated. However, extrapolation of the data to general practice must be cautions, as most of the trials were conducted in populations displaying a high absolute risk level, including few women, and excluding persons older than 75 years. However, subgroup analysis showed that the beneficial effect is independent of age and pretreatment lipid levels in the range studied. The precise lipid pattern should be considered before any treatment is started. Diet is the first step approach and should be continued even after introduction of lipid-lowering drug therapy. Statins are treatments of choice in case of hypercholesterolemia type IIa. The target level of LDL-cholesterol is less than 1.30 g/l in patients with known coronary heart disease. Fibrates may be useful in patients with hypertriglyceridemia, and/or low HDL-cholesterol level or in the case of intolerance to statins.
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