title: LDL cholesterol goals in high-risk patients: how low do we go and how do we get there?
abstract: It is widely recognised that low-density lipoprotein cholesterol (LDL-C) is one of the most important and modifiable risk factors for cardiovascular disease (CVD). Statins (HMG-CoA reductase inhibitors) have consistently been shown to decrease both LDL-C and CVD risk in almost all patient categories, with the exception of heart and kidney failure as well as advanced aortic stenosis. As a consequence, statins have become the cornerstone in current prevention guidelines. In patients who do not reach the LDL-C target, combination therapy with additional LDL-C lowering drugs (e.g. ezetimibe, bile acid sequestrants or fibrates) should be considered. Guidelines provide different LDL-C levels to strive for, depending on the CVD risk. In this review, we describe the rationale for these LDL-C targets and how these goals might be reached by current and future therapies.
authors.affiliation: Department of Vascular Medicine, Academic Medical Centre, Meibergdreef 15, Room F4-139, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: Besseling
authors.forename: Julian
authors.initials: J
authors.lastname: van Capelleveen
authors.forename: John J P
authors.initials: JJ
authors.lastname: Kastelein
authors.forename: G Kees
authors.initials: GK
authors.lastname: Hovingh
mesh_terms: D000924:Anticholesteremic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors