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News: Publications

New Featured commentary discussing early intervention and adherence

Tuesday 11 February 2020  
Posted by: Carmel Hayes
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February 2020

The 2019 ESC/EAS guidelines recommend lower LDL cholesterol levels to optimise global cardiovascular risk reduction. A key practical deterrent, however, is adherence. This month’s commentary discusses new evidence for early intervention to optimise population health, together with novel approaches that may offer solutions to the issue of poor adherence.

Targeting LDL cholesterol: early treatment is key to population health

Lower LDL cholesterol is better’ is a key premise of the 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS Guidelines for Dyslipidaemia).1 Low-density lipoprotein(LDL) is indisputably causal for atherosclerotic cardiovascular disease (ASCVD),2 and clinical data show no evidence of a threshold for clinical benefit from LDL-lowering.3,4 Indeed, it should be borne in mind that the LDL cholesterol goals in the ESC/EAS Guidelines are the maximum recommended levels for each global risk category, and that clinicians should aim for values below these wherever possible.

Given that atherosclerosis is a chronic inflammatory disease, it would make good clinical and economic sense to intervene against LDL cholesterol earlier, before the advent of subclinical disease. There has, however, been uncertainty regarding the clinical benefit derived at different baseline LDL cholesterol levels. This question (amongst others) was the focus of a recent meta-analysis.

Read the commentary in full >>


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