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New Insights Link Low HDL-Cholesterol and Elevated Triglycerides With Coronary Heart Disease and Microvascular Complications in Patients at Goal for LDL-Cholesterol
Date:9/1/2009

treated by clinicians," stated Professor Frank Sacks from Harvard Medical School, Boston, USA and Vice-president of R3i. "While LDL-C is appropriately the current target, we have taken LDL-C reduction to its therapeutic limits without abolishing CVD events. Therefore we urgently need new strategies to address other modifiable risk factors such as atherogenic dyslipidemia."

New insights into lipid-related macrovascular risk

Professor Gerd Assmann, member of the R3i International Steering Committee and President of the Board of the Assmann-Foundation for Prevention, presented a new analysis from PROCAM in which 823 men who survived a myocardial infarction (MI) were matched with an equal number of controls free from MI. This analysis, which was funded by the R3i, demonstrated:

    - Low HDL-C and/or elevated triglycerides (TG) was seen in
      nearly two-thirds of MI patients

    - When all risks factors were matched, the odds of experiencing a MI were
      increased five-fold for men with LDL-C at target (less than or equal to
      100mg/dL) presenting a low level of HDL-C (<45 mg/dL) and an elevated
      level of TG (>150 mg/dL)

The initial macrovascular findings of REALIST were also presented by Professor Frank Sacks, Vice-President of the R3i. This case-control study conducted in 170 patients hospitalized with CHD in Boston, USA, at goal for LDL-C, matched with 175 controls free from CHD shows that:

    - High TG and low HDL-C are strong indicators of residual risk of CHD

    - High TG and low HDL-C levels each contribute to the risk of a coronary
      event in patients with LDL-C levels less than or equal to 130 mg/dL or
      even less than or equal to 70 mg/dL

    - TG and HDL-C appear to act synergistically with the impact of TG
      increasing when HDL-C is low and the impact of HDL-C increasing when TG
      levels are high

    
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SOURCE Residual Risk Reduction Initiative Foundation
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