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Current Cardiology Reports

, Volume 14, Issue 6, pp 709–720 | Cite as

Dyslipidemias in the Prevention of Cardiovascular Disease: Risks and Causality

  • Ian Graham
  • Marie-Therese Cooney
  • David Bradley
  • Alexandra Dudina
  • Zeljko Reiner
Lipid Abnormalities and Cardiovascular Prevention (G De Backer, Section Editor)

Abstract

Atherosclerotic cardiovascular disease is now the major global cause of death, despite reductions in CVD deaths in developed societies. Dyslipidemias are a major contributor, but the mass occurrence of CVD relates to the combined effects of hyperlipidemia, hypertension, and smoking. Total blood cholesterol and LDL-cholesterol relate to CVD risk in an independent and graded manner and fulfill the criteria for causality. Therapeutic reduction of these lipid fractions is associated with improved outcomes. There is good evidence that HDL-cholesterol, triglycerides, and Lp(a) relate to CVD although the evidence for a causal relationship is weaker. The HDL association with CVD is largely independent of other risk factors whereas triglycerides may be more important as signaling a need to look intensively for other measures of risk such as central obesity, hypertension, low HDL-cholesterol, and glucose intolerance. Lp(a) is an inherited risk marker. The benefit of lowering it is uncertain, but it may be that its impact on risk is attenuated if LDL-cholesterol is low.

Keywords

Dyslipidemia Cholesterol LDL-cholesterol HDL-cholesterol Triglycerides Lp(a) Cardiovascular disease Risk prevention 

Notes

Disclosures

Conflicts of interest: I. Graham: has been on the Advisory panel for Merck Sharpe and Dohme; has received speaker fees from MSD, Pfizer, and Sanofi-Aventis; M.-T. Cooney: none; D. Bradley: none; A. Dudina: none; Z. Reiner: has been a consultant for AstraZeneca, Abbott, Sanofi-Aventis, and Bayer.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ian Graham
    • 1
  • Marie-Therese Cooney
    • 2
  • David Bradley
    • 3
  • Alexandra Dudina
    • 4
  • Zeljko Reiner
    • 5
  1. 1.Department of CardiologyCharlemont Clinic, Charlemont MallDublin 2Ireland
  2. 2.National Rehabilitation HospitalDublinIreland
  3. 3.Department of NeurologySt James’ HospitalDublin 8Ireland
  4. 4.Department of Respiratory MedicineTallaght Hospital, TallaghtDublin 24Ireland
  5. 5.Department of Internal MedicineUniversity Hospital Centre Zagreb, School of Medicine, University of ZagrebZagrebCroatia

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