Curing Atherosclerosis Should Be the Next Major Cardiovascular Prevention Goal

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in developed and developing countries. Despite decades of effort, unhealthy lifestyle habits and ASCVD risk factor levels remain high and are increasing in many population groups. A new approach to ASCVD prevention is neede...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2014-07, Vol.63 (25), p.2779-2785
Main Authors: Robinson, Jennifer G., MD, MPH, Gidding, Samuel S., MD
Format: Article
Language:English
Subjects:
Atherosclerosis
Atherosclerosis (general aspects, experimental research)
Atherosclerosis - prevention & control
Behavior
Biological and medical sciences
Blood and lymphatic vessels
Blood pressure
Cardiology
Cardiology. Vascular system
Cardiovascular
Cardiovascular Agents - therapeutic use
Cardiovascular disease
Child development
Cholesterol
Clinical trials
Decision Making
Diabetes
Gene expression
Heart
Humans
Hypotheses
Internal Medicine
Lifestyles
Lipoproteins
Medical imaging
Medical sciences
Middle age
Mutation
Older people
Population
Primary Prevention - methods
primordial prevention
Quality of life
regression
Risk assessment
Risk factors
Studies
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in developed and developing countries. Despite decades of effort, unhealthy lifestyle habits and ASCVD risk factor levels remain high and are increasing in many population groups. A new approach to ASCVD prevention is needed. Multiple lines of evidence from animal and human studies suggest that atherosclerosis regression and normalization of vessel function can occur when low-density lipoprotein cholesterol (LDL-C) lowering occurs early in the course of atherosclerosis or when very aggressive LDL-C lowering occurs somewhat later. We propose a new paradigm focused on curing atherosclerosis early in the course of the disease. An approach that resets the vascular aging clock composed of initial regression therapy followed by periodic retreatment to suppress atherosclerosis development may be possible, with the ultimate goal of preventing subsequent ASCVD events. Proof-of-concept studies are needed to determine: 1) the optimal age and/or extent of atherosclerosis for intervention and LDL-C–lowering therapy; 2) the intensity and duration of therapy for inducing atherosclerosis regression; and 3) documenting the normalization of vascular function. Ultimately, this new paradigm will need to be evaluated in ASCVD outcomes trials.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2014.04.009