Key Points Purpose of this Guideline
ÎReview, briefly, basic lipid and lipoprotein terminology. ÎIntroduce population cutpoints for lipid and lipoprotein values.
ÎDefine cardiovascular disease (CVD) risk criteria and describe how to apply these criteria to assess individual patient risk.
ÎPresent the goals of therapy with regard to risk classification, recommend the means of achieving them, and discuss potential therapies.
Key Points
ÎHydrophobic cholesterol, other sterols, triglycerides and phospholipids are trafficked within apolipoprotein-wrapped particles called lipoproteins.
ÎAtherosclerosis results from a buildup of cholesterol-laden macrophages in the arterial intima. This occurs when atherogenic lipoprotein particles (principally low-density lipoprotein [LDL]) enter the arterial wall, become oxidized, and are subsequently ingested by macrophages.
ÎMovement of atherogenic lipoproteins into the arterial intima occurs in a gradient-driven process—the greater the concentration of LDL particles in plasma the greater their entry into the arterial wall.
ÎClinical management of lipid/lipoprotein-related cardiovascular risk requires:
• Assessment of cardiovascular risk: utilization of history (current, past, and family), physical examination (especially blood pressure [BP], body mass index [BMI], and waist size), and conventional and novel biomarker risk factors to determine the magnitude of CVD risk present for a given individual. (See Table 2)
• Management of lipoprotein-related risk: use of lifestyle changes, as well as medications as indicated, to achieve optimal lipid and lipoprotein values appropriate for the magnitude of CVD risk identified.
