There is urgent need to treat atherosclerotic cardiovascular disease risk earlier, more intensively, and with greater precision: A review of current practice and recommendations for improved effectiveness

Imaging subclinical coronary atherosclerosis to guide lipid management, are we there yet?

“…When starting lipid lowering therapies it is essential to understand the effects on lipid parameters and cardiovascular risk. In both primary and secondary prevention, it is established that for every 40 mg/dL LDL-C reduction in patients treated with statins, there is a 23% reduction of events in 5 years ( Table 3 ) [ 124 ]. Furthermore, multiple trials have reported no systemic increase in adverse events in those achieving LDL-C <50 mg/dL [ 125 ], which may be appropriate for patients with high risk imaging findings.…”

Aggressive LDL-C Lowering and the Brain: Impact on Risk for Dementia and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association

“…Although debated, there is an emerging consensus that a truly physiological, nonpathogenic LDL-C level in humans is ≈25 to 60 mg/dL. 9–12 However, concern remains about potential for neurologic toxicity when LDL-C is reduced to low (<70 mg/dL) and very low (<25 mg/dL) levels. In the Multiple Risk Factor Intervention Trial, a total cholesterol of <160 mg/dL was associated with an increased risk for hemorrhagic stroke compared with total cholesterol that exceeded this threshold in men with diastolic hypertension.…”

Dose–response relationship between physical activity and cardiometabolic risk in obese children and adolescents: A pre-post quasi-experimental study

“…Notably, unlike previous studies ( Wong et al, 2008 ; González-Ruíz et al, 2022 ; Meng et al, 2022 ) with longer intervention periods (12 weeks or longer), the obese children and adolescents in this study achieved significant health improvement after 4 weeks of exercise, suggesting that even short-period exercise interventions can achieve improved cardiometabolic health in obese children and adolescents. Elevated LDL-C is a necessary condition for atherogenesis induction, and no evidence of any clinically significant harm no matter how low the LDL-C level ( Makover et al, 2022 ). Intervention such as exercise to reduce LDL-C levels in obese children and adolescents is crucial for the prevention of CVD.…”