Lipid metabolism can be disturbed in different ways, leading to changes in plasma lipoprotein function and/or levels6.
Elevated plasma total cholesterol (TC) and in particular LDL-cholesterol is a known cause of coronary atherosclerosis6,7.
Established and compelling evidence based on outcomes from multiple randomized controlled trials (RCTs) has shown that reducing TC and LDL-cholesterol levels can significantly reduce cardiovascular morbidity and mortality7.
In terms of reducing cardiovascular events and CVD mortality, lowering LDL-cholesterol has been shown to be beneficial irrespective of the underlying mechanisms by which this is achieved (reduced absorption or synthesis, or increased clearance of cholesterol)7.
Atherosclerosis, the underlying cause of CVD, is a slowly progressive disease that begins early in life and develops over several decades before becoming clinically manifested. It is a dynamic process however and it can be slowed down and potentially reversed to an extent8.
Prolonged exposure to lower LDL-cholesterol beginning early in life is associated with a substantially greater reduction in the risk of CHD compared to treating high LDL-cholesterol levels later in life7,9. Therefore, lowering LDL-cholesterol earlier in the disease process, through changes towards a healthy diet and lifestyle, and eventually resorting to drug therapies, should be encouraged for the prevention of CVD.