QJM Advance Access published online on June 4, 2009
QJM, doi:10.1093/qjmed/hcp065
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Dyslipidemia and cardiovascular risk: the importance of early prevention
From the Center for Preventive Cardiology, Division of Cardiology, University of Maryland Medical Center, Baltimore, MD 21201, USA
Address correspondence to M. Miller, M.D., F.A.C.C., F.A.H.A., Center for Preventive Cardiology, Division of Cardiology, University of Maryland Medical Center, 22 South Greene Street, Room S3B06, Baltimore, MD 21201, USA. email: Mmiller{at}medicine.umaryland.edu
Received 29 January 2009 and in revised form 27 April 2009
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Abstract |
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Strategies aimed at primary prevention provide an outstanding opportunity for reducing the onset and burden of cardiovascular (CV) disease. Lipid abnormalities, including high levels of low-density lipoprotein cholesterol (LDL-C), elevated triglycerides and low levels of high-density lipoprotein cholesterol (HDL-C), are associated with an increased risk of CV events, thereby serving as contributors to this process. By consensus, lowering LDL-C, generally with statin therapy, is the primary target of lipid-lowering therapy. However, statin therapy may be insufficient for patients with mixed dyslipidemia, especially those with insulin resistance syndromes. While the addition of niacin, fibrate or omega-3 fatty acids may be useful in this setting, outcomes data are lacking. Therefore, data from ongoing prospective studies will hopefully resolve this issue and facilitate identification of optimal strategies to augment CV risk reduction.