Modern concepts on cholesterol lowering and coronary heart disease

V. Papademetriou, P. Kokkinos

Research output: Contribution to journalReview article

Abstract

The association between abnormal blood lipids and coronary disease has been well established in population studies. Several clinical trials have also demonstrated a causal relationship between total cholesterol or LDL- cholesterol and coronary heart disease. Thus, the aggressive management of hypercholesterolemia is warranted. However, early studies using fibrates demonstrated a reduction in CHD mortality, but an increase in non-CHD and total mortality raising suspicion in the use of medication to treat hypercholesterolemia. The recently introduced new class of lipid lowering agents, the HMG-Co-A reductase inhibitors, have dispersed these suspicions and made the management of hypercholesterolemia an attainable goal. These agents are well tolerated by patients with few and relatively mild side- effects. Primary and secondary prevention trials using these agents reported impressive reductions in cardiovascular and non-cardiovascular death. Aggressive lipid lowering therapy appears to stabilize the atherosclerotic plaque without an appreciable reduction in its size. A more stable plaque is less likely to rapture and lead to an acute ischemic syndrome. It has also been shown that lowering blood cholesterol will lead to improved endothelial function. Hypercholesterolemia is suspected to impair nitric oxide release, a principal modulator af vascular tone and prevention of platelet and leucocyte adhesion.

Original languageEnglish (US)
Pages (from-to)359-369
Number of pages11
JournalHellenic Journal of Cardiology
Volume38
Issue number5
StatePublished - Dec 1 1997
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Keywords

  • Cholesterol
  • Coronary heart disease
  • Plaque regression

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