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Posted on Tuesday March 19, 2024 in Cholesterol & Atherosclerosis
Tags: Cholesterol, Coronary heart disease, CHD, PCSK9, Statin, LDL, search website using Tags to find related stories.
The latest European and UK guidelines reflect the finding that there is no lower limit for LDL yet discovered, basically meaning the lower the LDL the lower the risk of future cardiovascular events. These recommendations come after new trials with lower targets showed better outcomes. As a result, millions of people taking statins around the world need to be looking more carefully at whether they are taking sufficient medication to lower their LDL to these new targets if the very best outcomes are to be achieved.
Summary table showing the target LDL recommended by the European Society of Cardiology from reference [2] Mach F, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020 Jan 1;41(1):111-188. doi: 10.1093/eurheartj/ehz455
Some research suggests that non-HDL cholesterol may be a better predictor of heart disease than LDL cholesterol. This is because non-HDL cholesterol includes all the atherogenic lipoprotein particles, which transport triglycerides to tissues. These particles eventually turn into LDL. The NHS elected to simplify population blood testing for lipids, by measuring a random (non fasting) total blood cholesterol and HDL Cholesterol fraction. The term ‘non HDL cholesterol’ is widely used as an approximate equivalent to LDL and is simply derived by subtracting the HDL from Total Cholesterol.
For patients who have been diagnosed with an acute coronary syndrome, requiring bypass surgery or stent, or have CT Angiography and or raised FAI where the risk of future coronary events is increased, effective secondary prevention is required. The target LDL in such patients has been lowered to <1.8 mmol/L.
Download the guideline as PDF Locally-developed-Lipid-SCVC
Continuous glucose monitors reveal how differently individuals respond to carbohydrates. We classify these responses using Glucotype, which reflects innate carbohydrate tolerance, and Current Glucose Profile (CGP), which shows a person’s present metabolic state. Combined with visceral fat grading, this system helps identify metabolic risk and guide personalised dietary or medical interventions.
Aspirin, or acetylsalicylic acid, is one of the oldest and most widely used medications in the world. Well known for its analgesic effects, it was later discovered to be effective in much smaller doses in preventing platelet aggregation that had a pivotal role in arterial thrombosis. Its role in inhibiting platelet activity has made it a cornerstone in the prevention and treatment of arterial thrombosis. In this article, we will explore the fascinating role of platelets in acute coronary thrombosis, the mechanisms by which aspirin exerts its protective effects, and the clinical considerations for its use.
One of the greatest challenges in the online world is investigator bias. Any “expert” with a strong conviction — whether pro- or anti-statin — can easily find studies that appear to confirm their view. The internet is full of such cherry-picked data. When presented with confident authority, this can sound utterly convincing to a lay audience. The reality is that true medical understanding does not come from one paper, one YouTube video, or one self-proclaimed authority.