Cholesterol-Lowering Therapy in Patients at Low-to-Moderate Cardiovascular Risk

Abstract

Elevated low-density lipoprotein cholesterol (LDL-C) is unanimously recognized as a major modifiable risk factor related to the development of atherosclerotic cardiovascular disease (ASCVD). Consistent evidence confirms that reducing LDL-C is associated with reduction of major adverse cardiovascular events (MACEs), with benefits proportionally related to initial individual CV risk and absolute reduction of LDL-C levels. The recent European guidelines on cardiovascular prevention have proposed a revised approach in cardiovascular risk evaluation, taking into account a renewed consideration of the interaction between risk factors and possible confounding factors (e.g., age). Although for patients considered to be at high and very high cardiovascular risk the need for stringent risk factors treatment is clearly stated, for those who are at lowto-moderate cardiovascular risk the issue is more debated. For those latter subjects, current guidelines indicate that risk factor treatment is generally not necessary, unless the impact of CV risk modifiers, lifetime CV risk and treatment benefit may be substantial. In addition, despite the estimated low-to-moderate short-term CV risk, the early appearance of even mild LDL-C level elevations may contribute to impair long-term CV prognosis. Therefore, encouraging the achievement of desired LDL-C goals through tailored conservative lifestyle changes and, if necessary, pharmacologic strategies should not be excluded categorically in all low-to-moderate risk individuals. In this review, we summarize the most recent evidence that may influence the choice to treat or not to treat LDL-C elevations in subjects at low-to-moderate risk and the suggested therapeutic tools aimed at achieving the recommended LDL-C goals.

Effect of turmeric starch, lecithin, and canola oil supplements on waffles quality

“…As such, in this study, canola oil was used along with curcumin (from turmeric) in a waffle recipe with potential health benefits. Important possible benefits are cholesterol reduction and increased cardiovascular protection, antioxidant effects, and anti-inflammatory properties (Figorilli et al, 2022).…”

The Dynamics of Cardiovascular Risk—An Analysis of the Prospective Urban Rural Epidemiology (PURE) Poland Cohort Study

“…This is supported by other analyses reporting that lowering LDL-c levels significantly reduces the incidence of myocardial infarction, revascularization or ischemic stroke [24]. Therefore, as Figorilli et al emphasize, early identification of patients with LDL-c abnormalities and appropriate 10-year CVR stratification are the cornerstones of CVD prevention [25].…”

Atherosclerotic cardiovascular disease landscape in Singapore

“…It is now recognized that an elevated LDL-C level is a major modifiable risk factor for ASCVD ( 8 ). Various studies have confirmed that lowering LDL levels is associated with better cardiovascular outcomes ( 40 ).…”

“…We review the burden of CVD, trends in risk factor control, preventive care, disparities, and current unmet needs in the management of ASCVD in Singapore. This review particularly focusses on elevated low-density lipoprotein cholesterol (LDL-C), which is unanimously recognized as a major modifiable risk factor in the management of ASCVD ( 8 ).…”