Hypertriglyceridemia: A Review of Clinical Relevance and Treatment Options: Focus on Cerivastatin

Hans-Willi M. Breuer, Abteilung für Innere Medizin, St. Carolus-Krankenhaus Görlitz, Carolusstr. 212, 02827 Görlitz, Germany 

Curr Med Res Opin. 2001;17(1):60-73. 

In This Article

Risk Factors in Coronary Heart Disease

Heart disease has a multifactorial aetiology and contributory factors arise from aspects of an individual's lifestyle, family history, and other illnesses and their treatment[7,8,9]. Clinical research has found many independent risk factors associated with cardiovascular disease[1,2]. These include lipid (low HDL-C level, high TG level and high LDL-C/HDLC ratio > 5) and non-lipid (elevated systolic blood pressure, smoking, diabetes, age > 60 years, men and post-menopausal women, and a positive family history) risk factors. Total cholesterol (TC) level alone is now known not to be an independent predictor of increase risk of cardiovascular events[5], although clinically it is used as such, as it reflects the values of the other lipid variables (e.g. LDL-C, TG and HDL-C).

Risk assessment and treatment algorithms included in the ESC,[11,12,15,16] AHA[14,17] and NCEP[7,8,9,10] guidelines, for example, have been devised from data provided by prospective heart studies (such as the ESC survey[16], the Münster Heart Study[PROCAM][3,24,41,42] and the Framingham study[2,4,5]) for identifying individuals at high risk for CHD.Individual factors from the clinical history,investigations and examinations are used to assess the risk depending on the relative extent of their role in CHD aetiology. As a result of this work, it is now relatively simple to categorise the level of risk for an individual patient and treat accordingly.

Although these risk prediction models are simple and straightforward to use, they are not reliable in all individuals[9]. For example, many asymptomatic individuals are still tested only for TC levels when there is ample evidence to show that TC is not an independent predictor of risk in CHD[43,44]. In fact,many individuals with normal TC levels could be at high, or even very high, risk of CHD[43,44].

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