Low-Density Lipoprotein Cholesterol (LDL-C): How Low?

Title:Low-Density Lipoprotein Cholesterol (LDL-C): How Low?

Volume: 15 Issue: 4

Author(s): Thomas F. Whayne*

Affiliation:

• Wethington Building, 900 South Limestone Street, Lexington, KY 40536-0200,United States

Keywords: Coronary artery disease, low-density lipoprotein cholesterol, peripheral arterial disease, proprotein convertase subtilisin/ kexin type 9, statins.

Abstract: Low-density lipoprotein cholesterol (LDL-C) is a well-established major cardiovascular (CV) risk factor supported by clinical evidence showing decreased atherosclerotic disease events when LDL-C is therapeutically lowered. A reasonable approach is to tailor each patient’s LDL-C target level depending on the initial LDL-C level and the perceived risk. Multiple clinical entities such as the newborn, hypobetalipoproteinemia, proprotein convertase subtilisin/kexin type 9 (PCSK9) missense mutations, and an unexpected excess response to a statin or other medications, are associated with very low LDL-C levels in otherwise healthy individuals. Therefore, an issue of major interest to clinicians who buy into “lower is better” for LDL-C in the high-risk CV patient is how low can and should the LDL-C be taken? Available information is discussed and placed into context. A definite safe lowest LDL-C level cannot be specified but there appears to be support that a level as low as 20 mg/dL (0.52 mmol/l) can be justified in the highest CV risk patients with extensive atherosclerosis where plaque stabilization and regression are necessary.

Cite this article as:

Whayne F. Thomas*, Low-Density Lipoprotein Cholesterol (LDL-C): How Low?, Current Vascular Pharmacology 2017; 15(4) . https://dx.doi.org/10.2174/1570161115666170227102708