Determine if evidence supports interventions to prevent development of atherosclerosis and atherosclerotic cardiovascular disease (ASCVD) events and death.
An extensive body of evidence supports the fundamental causal role of apolipoprotein B lipoproteins in the development of atherosclerosis. Recent epidemiologic studies have shown that LDL-cholesterol (LDL-C) and non-HDL-cholesterol levels in early adults are associated with accelerated subclinical atherosclerosis and an excess of atherosclerotic cardiovascular events later in life. Animal and human data have shown that intensive LDL-C lowering can regress earlier stages of atherosclerosis.
The next research priority is evaluating the impact of lowering LDL-C earlier in life to regress early atherosclerosis, followed by trials to demonstrate this approach will eradicate later-life ASCVD events and death. This approach of curing atherosclerosis will likely be the most effective strategy for reducing the huge global burden of atherosclerosis.
aDepartments of Medicine (Cardiology) and Preventive Medicine, Northwestern University Feinberg School of Medicine Chicago, IL
bFH Foundation Pasadena, California
cDepartments of Epidemiology & Medicine, Prevention Intervention Center, Iowa City, Iowa, USA
Correspondence to Jennifer G. Robinson, MD, MPH, Director, Departments of Epidemiology & Medicine, Prevention Intervention Center, 145 N Riverside Dr S455 CPHB, Iowa City, IA 52242, USA. Tel: +1 319 384 1563/+1 319 384 4010; fax: +1 319 384 4155; e-mail: Jenniferfirstname.lastname@example.org