Article ; Online: Residual Atherosclerotic Cardiovascular Disease Risk: Focus on Non-High-Density Lipoprotein Cholesterol.
Journal of cardiovascular pharmacology and therapeutics
2023 Volume 28, Page(s) 10742484231189597
Abstract: Cardiovascular disease (CVD) caused by atherosclerosis is the leading cause of death worldwide. The level of low-density lipoprotein cholesterol (LDL-C), considered as the initiator of atherosclerosis, is the most widely used predictor for CVD risk and ... ...
| Abstract | Cardiovascular disease (CVD) caused by atherosclerosis is the leading cause of death worldwide. The level of low-density lipoprotein cholesterol (LDL-C), considered as the initiator of atherosclerosis, is the most widely used predictor for CVD risk and LDL-C has been the primary target for lipid-lowering therapies. However, residual CVD risk remains high even with very low levels of LDL-C. This residual CVD risk may be due to remnant cholesterol, high triglyceride levels, and low high-density lipoprotein cholesterol (HDL-C). Non-high density lipoprotein cholesterol (non-HDL-C), which is calculated as total cholesterol minus HDL-C (and represents the cholesterol content of all atherogenic apolipoprotein B-containing lipoproteins), has emerged as a better risk predictor for CVD than LDL-C and an alternative target for CVD risk reduction. Major international guidelines recommend evaluating non-HDL-C as part of atherosclerotic CVD risk assessment, especially in people with high triglycerides, diabetes, obesity, or very low LDL-C. A non-HDL-C target of <130 mg/dL (3.4 mmol/L) has been recommended for patients at very high risk, which is 30 mg/dL (0.8 mmol/L) higher than the corresponding LDL-C target goal. Non-HDL-C lowering approaches include reducing LDL-C and triglyceride levels, increasing HDL-C, or targeting multiple risk factors simultaneously. However, despite the growing evidence for the role of non-HDL-C in residual CVD risk, and recommendations for its assessment in major guidelines, non-HDL-C testing is not routinely done in clinical practice. Thus, there is a need for increased awareness of the need for non-HDL-C testing for ascertaining CVD risk and concomitant prevention of CVD. |
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| MeSH term(s) | Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Cholesterol, LDL ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Cholesterol ; Triglycerides ; Risk Factors ; Lipoproteins/therapeutic use ; Cholesterol, HDL ; Atherosclerosis/diagnosis ; Atherosclerosis/epidemiology ; Atherosclerosis/prevention & control |
| Chemical Substances | Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Cholesterol, LDL ; Cholesterol (97C5T2UQ7J) ; Triglycerides ; Lipoproteins ; Cholesterol, HDL |
| Language | English |
| Publishing date | 2023-08-27 |
| Publishing country | United States |
| Document type | Journal Article ; Review ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 1329372-2 |
| ISSN | 1940-4034 ; 1074-2484 |
| ISSN (online) | 1940-4034 |
| ISSN | 1074-2484 |
| DOI | 10.1177/10742484231189597 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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