Dyslipidemia is a major cause of coronary heart disease (CHD)—the most-common cause of death in the Western world—and is characterized by increased levels of total cholesterol, LDL cholesterol, and/or triglycerides, decreased levels of HDL cholesterol, modified function of lipid molecules, or a combination of some or all of these factors. Although mortality rates from CHD have reduced substantially over the past few decades, owing largely to the use of LDL-lowering statins, further strategies for reducing CHD risk are still urgently needed. Given the considerable global impact of dylipidemia, and the accumulating data on risk prediction and mechanisms of disease that have generated multiple potential targets for treatment, we have commissioned a group of articles that review the latest advances in risk assessment, biological mechanisms of disease protection, and diagnosis and management of this disorder.
EDITORIAL
Targeting levels and functions of blood lipids in the prevention of CVD
Bryony M. Mearns
doi:10.1038/nrcardio.2011.42
Nature Reviews Cardiology 8, 179-180 (2011)
NEWS & VIEWS
Atherosclerosis: Targeting endogenous apo A-I—a new approach for raising HDL
Prediman K. Shah
doi:10.1038/nrcardio.2011.37
Nature Reviews Cardiology 8, 187-188 (2011)
REVIEWS
Utility of genetic determinants of lipids and cardiovascular events in assessing risk
Michael V. Holmes, Seamus Harrison, Philippa J. Talmud, Aroon D. Hingorani & Steve E. Humphries
doi:10.1038/nrcardio.2011.6
Nature Reviews Cardiology 8, 207-221 (2011)
Genetic testing is an attractive tool for CHD risk prediction; however, the process of harnessing genetic information to improve population health is in its infancy. In this article, Dr Holmes and colleagues discuss the numerous challenges faced by researchers and clinicians, and suggest a change of focus to better exploit the opportunities offered by the unique properties of genetic information.
HDL and cardiovascular disease: atherogenic and atheroprotective mechanisms
Mohamad Navab, Srinivasa T. Reddy, Brian J. Van Lenten & Alan M. Fogelman
doi:10.1038/nrcardio.2010.222
Nature Reviews Cardiology 8, 222-232 (2011)
Although high levels of HDL seem to be protective against clinical events from atherosclerosis, assessing the composition and function of HDL is a more-accurate approach to determine cardiovascular risk. The authors of this Review describe the atheroprotective effects of HDL, which have been attributed to its anti-inflammatory properties and role in cholesterol efflux. The relationship between impaired HDL function and cardiovascular disease is also discussed, as well as approaches to evaluate HDL functionality.
Lipid parameters for measuring risk of cardiovascular disease
Benoit J. Arsenault, S. Matthijs Boekholdt & John J. P. Kastelein
doi:10.1038/nrcardio.2010.223
Nature Reviews Cardiology 8, 197-206 (2011)
The benefits of lowering LDL-cholesterol levels to prevent clinical events are well-recognized. However, other parameters of the lipoprotein–lipid profile are likely to contribute to cardiovascular risk and should be used in addition to the traditional lipid profile for improved assessment of cardiovascular risk. The authors of this Review discuss alternative and emerging lipid parameters associated with cardiovascular disease that could identify patients at high risk and those who will benefit most from lipid-lowering therapy.
Novel HDL-directed pharmacotherapeutic strategies
Emil M. deGoma & Daniel J. Rader
doi:10.1038/nrcardio.2010.200
Nature Reviews Cardiology, advance online publication, Published online 18 January 2011
Novel atheroprotective therapies are needed to address the residual risk associated with atherothrombotic cardiovascular disease. In this Review, Drs deGoma and Rader discuss the mechanisms of HDL-targeted drugs, including agents that enhance or mimic apolipoprotein A-I activity, and summarize the development of these pharmacotherapies in preclinical and clinical studies.
Pharmacological strategies for lowering LDL cholesterol: statins and beyond
Ariel Brautbar & Christie M. Ballantyne
doi:10.1038/nrcardio.2011.2
Nature Reviews Cardiology, advance online publication, Published online 15 February 2011
The relationship between an elevated level of LDL cholesterol (LDL-C) and increased risk of cardiovascular disease is well established. National and international guidelines are continuously being revised to recommend increasingly lower LDL-C targets for cardiovascular disease prevention. In this Review, Drs. Brautbar and Ballantyne examine the evidence and recommendations for optimal LDL-C levels and the agents currently available or under development to achieve these levels.
Lipid control in patients with diabetes mellitus
D. John Betteridge
doi:10.1038/nrcardio.2011.23
Nature Reviews Cardiology, advance online publication, Published online 15 March 2011
Patients with type 1 or type 2 diabetes mellitus are at increased risk of cardiovascular disease (CVD). In this Review, the author discusses available data from randomized controlled trials of statins and other dyslipidemia-management agents that provide a framework to guide primary and secondary prevention of CVD in these populations.
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