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Dyslipidemias in the Prevention of Cardiovascular Disease: Risks and Causality

  • Lipid Abnormalities and Cardiovascular Prevention (G De Backer, Section Editor)
  • Published:
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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.

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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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Authors and Affiliations

  1. Department of Cardiology, Charlemont Clinic, Charlemont Mall, Dublin 2, Ireland

    Ian Graham

  2. National Rehabilitation Hospital, Dun Laoghaire, Co., Dublin, Ireland

    Marie-Therese Cooney

  3. Department of Neurology, St James’ Hospital, Dublin 8, Ireland

    David Bradley

  4. Department of Respiratory Medicine, Tallaght Hospital, Tallaght, Dublin 24, Ireland

    Alexandra Dudina

  5. Department of Internal Medicine, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia

    Zeljko Reiner

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  1. Ian Graham
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  2. Marie-Therese Cooney
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  4. Alexandra Dudina
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Correspondence to Ian Graham.

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Graham, I., Cooney, MT., Bradley, D. et al. Dyslipidemias in the Prevention of Cardiovascular Disease: Risks and Causality. Curr Cardiol Rep 14, 709–720 (2012). https://doi.org/10.1007/s11886-012-0313-7

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