A review of low-density lipoprotein cholesterol, treatment strategies, and its impact on cardiovascular disease morbidity and mortality

Abstract

Cardiovascular (CV) disease is a leading cause of death worldwide, accounting for approximately 31.4% of deaths globally in 2012. It is estimated that, from 1980 to 2000, reduction in total cholesterol accounted for a 33% decrease in coronary heart disease (CHD) deaths in the United States. In other developed countries, similar decreases in CHD deaths (ranging from 19%-46%) have been attributed to reduction in total cholesterol. Low-density lipoprotein cholesterol (LDL-C) has now largely replaced total cholesterol as a risk marker and the primary treatment target for hyperlipidemia. Reduction in LDL-C levels by statin-based therapies has been demonstrated to result in a reduction in the risk of nonfatal CV events and mortality in a continuous and graded manner over a wide range of baseline risk and LDL-C levels. This article provides a review of (1) the relationship between LDL-C and CV risk from a biologic, epidemiologic, and genetic standpoint; (2) evidence-based strategies for LDL-C lowering; (3) lipid-management guidelines; (4) new strategies to further reduce CV risk through LDL-C lowering; and (5) population-level and health-system initiatives aimed at identifying, treating, and lowering lifetime LDL-C exposure.

Formulation of Zero-Trans Crystalized Fats Produced from Palm Stearin and High Oleic Safflower Oil Blends

“…It is known that TFA increases low-density lipoprotein (LDL) serum levels. If the blood keeps excess levels of LDL-cholesterol there is an increased risk of cardiovascular diseases [2][3][4][5]. The concentration of palmitic acid was highest in all blends of PS/HOSO.…”

“…TFA have negative health implications especially in terms of the ratio of high-density to low-density lipoproteins, which is correlated with risk of cardiovascular diseases [2]. Several published reports have indicated that TFA have also adverse effects on serum cholesterol, triglyceride levels, and coronary heart diseases [3,4]. The harmful effects of TFA on the ratio of total cholesterol to HDL cholesterol are reported to be twice compared to saturated FA [5].…”

Estimated burden of cardiovascular disease and value-based price range for evolocumab in a high-risk, secondary-prevention population in the US payer context

“…Elevated low-density lipoprotein-cholesterol (LDL-C) is a key risk factor for CVD, and reduction of LDL-C is recommended in clinical practice guidelines to reduce morbidity and mortality 1,4 . The primary treatment used to reduce LDL-C is statin therapy, which has been shown to reduce the rate of CV events in both primary-and secondary-prevention patients 7 . Recent meta-analyses of statin trials by the shown that statins reduce vascular mortality by 12% and major CV events by 21% per 1 mmol/L (38.67 mg/dL) of LDL-C reduction 8,9 .…”

Statins and Cholesterol: A Perspective Revisited

“…Worth to mention here, LDL is not just carrier of cholesterol but also serves as reservoir to transport fats, vitamin D and fat soluble antioxidants. [21] The cholesterol present in outer shell of LDL serves as a protective layer to prevent oxidation of fats in lipoproteins. Moreover, it has been found that LDL cholesterol also protects ApoB protein from attack of glucose or fructose.…”