Lipoproteins and cardiovascular disease: biological basis and epidemiological studies.

There is a long history to our understanding of the biological basis of lipoproteins in cardiovascular disease and to the key epidemiological studies in this field. Building on a wealth of laboratory evidence explaining the role of cholesterol and lipoproteins in the pathogenesis of atherosclerosis, epidemiological studies have characterized associations between serum lipid abnormalities and the risk of myocardial infarction. While elevation in total cholesterol has been associated with an increased risk of myocardial infarction, this information alone is not sufficient.

Making practical sense of clinical trial data in decreasing cardiovascular risk.

Clinical studies now affirm what epidemiologic evidence has long suggested-that a broad range of patients can benefit from lipid reduction, including those without overt coronary artery disease and only moderate lipid elevations. Together, these studies suggest that current goals for cholesterol reduction may not be sufficiently stringent to slow the epidemic of heart disease in this country and that aggressive lipid lowering may be just what the doctor should order.