The Success Story of LDL Cholesterol Lowering

Circ Res. 2016 Feb 19;118(4):721-31. doi: 10.1161/CIRCRESAHA.115.306297.

Abstract

We can look back at >100 years of cholesterol research that has brought medicine to a stage where people at risk of severe or fatal coronary heart disease have a much better prognosis than before. This progress has not come about without resistance. Perhaps one of the most debated topics in medicine, the cholesterol controversy, could only be brought to rest through the development of new clinical research methods that were capable of taking advantage of the amazing achievements in basic and pharmacological science after the second World War. It was only after understanding the biochemistry and physiology of cholesterol synthesis, transport and clearance from the blood that medicine could take advantage of drugs and diets to reduce the risk of atherosclerotic diseases. This review points to the highlights of the history of low-density lipoprotein-cholesterol lowering, with the discovery of the low-density lipoprotein receptor and its physiology and not only the development of statins as the stellar moments but also the development of clinical trial methodology as an effective tool to provide scientifically convincing evidence.

Keywords: atherosclerosis; cholesterol, LDL; coronary artery disease; primary prevention; secondary prevention.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Animals
  • Anticholesteremic Agents / adverse effects
  • Anticholesteremic Agents / history
  • Anticholesteremic Agents / therapeutic use*
  • Biomarkers / blood
  • Cholesterol, LDL / blood*
  • Clinical Trials as Topic
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / history
  • Coronary Artery Disease / prevention & control*
  • Diet, Fat-Restricted
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / diagnosis
  • Hypercholesterolemia / drug therapy*
  • Hypercholesterolemia / history
  • Primary Prevention
  • Risk Assessment
  • Risk Factors
  • Secondary Prevention
  • Treatment Outcome

Substances

  • Anticholesteremic Agents
  • Biomarkers
  • Cholesterol, LDL