[Lipids and primary prevention of coronary disease]

In this paper the data concerning the relationship between presence of lipid disorders and development of atherosclerosis are presented. The epidemiological studies showed that lipid disorders in young persons are of prognostic significance concerning future development of cardiovascular disease. Large, placebo controlled clinical trials demonstrated that reduction of serum cholesterol was associated with reduction in incidence of cardiovascular disease, however the decrease in total mortality (by 22%, p < 0.051) was observed only with statin treatment in WOSCOPS. Hyperlipidemia is associated with impairment of endothelial function, loss of endothelium dependent vasodilatation, development of inflammatory responses and impairment of anticoagulant function. Hypolipidemic therapy leads to improvement of endothelial function and stabilisation of atherosclerotic changes. Modification of all existing risk factors is of importance in prevention of cardiovascular diseases.