Current guidelines on prevention with a focus on dyslipidemias

Abstract

Examination of the current the American College of Cardiology/American Heart Association (ACC/AHA) and European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines on the prevention of cardiovascular disease and the management of dyslipidemias finds much common ground. Both note that Atherosclerotic cardiovascular disease (ASCVD) is, in most people, the product of a number of risk factors, notably tobacco exposure, hyperlipidemia, hypertension, inactivity, overweight and diabetes. They stress that risk calculators can help in the assessment of risk in apparently healthy persons. Persons with established ASCVD and many with diabetes or renal impairment are at high to very high risk and warrant intensive risk factor advice and guideline-based preventive therapies. The ACC/AHA guidelines favor the universal use of statins in all high-risk subjects and in primary prevention where the global risk exceeds 7.5% in 10 years, with a percentage reduction in low-density lipoprotein cholesterol (LDL-C) based on statin intensity as the "goal". In contrast, the ESC/EAS guidelines favor a goal or percentage-based reduction in LDL-C based on total risk and baseline LDL-C level. Both guidelines consider certain imaging and other measures to stratify risk as well as the use of non-statin therapies in those not achieving recommended targets. Perhaps the most important challenges are to stress similarities rather than differences, and to simplify communications with both healthcare professionals and the public.

MDG-1, a Potential Regulator of PPARα and PPARγ, Ameliorates Dyslipidemia in Mice

“…The recent decades demonstrated excessive caloric intake and sedentary living habits, leading to increasing energy imbalances and ultimately resulting in obesity as well as hyperlipidemia (as public health problems, obesity, and hyperlipidemia are the main incentives of metabolic disorders (MetS) such as diabetes and hypertension with relatively high mortality [ 6 , 22 , 23 ]). Here, our test shows that MDG-1 has a protective effect on abdominal obesity and the disturbance of lipid metabolism.…”

Attenuation of atherogenic apo B-48-dependent hyperlipidemia and high density lipoprotein remodeling induced by vitamin C and E combination and their beneficial effect on lethal ischemic heart disease in mice

“…This disease is mainly due to atherosclerosis, and therefore is strongly associated to dyslipidemia, oxidative stress and inflammation [ 1 ]. Atherogenic dyslipidemia is mainly characterized by an increase in LDL and/or a decrease in HDL levels [ 2 ]. HDL particles are recognized as a protective factor against cardiovascular disease since they promote several atheroprotective functions [ 3 ] and their increment by 1 mg/dL is linked to an average decrease of 3% in the risk for development of CVD [ 4 , 5 ].…”

Low density lipoprotein-induced lipid accumulation is a key phenomenon of atherogenesis at the arterial cell level

“…Unfortunately, modified LDL is not used in American and European recommendations and guidelines for reducing the risk of developing atherosclerotic cardiovascular diseases [32][33][34] . This is the result of the fact that the available data from clinical studies do not allow us to justify the use of modified LDL and HDL as mechanistic biomarkers of atherosclerotic disease.…”