Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
Servicio de Cardiología, Hospital Arnau de Vilanova, Valencia, España; Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad CEU-Cardenal Herrena, Moncada, Valencia, España.
Clin Investig Arterioscler. 2021 May;33 Suppl 1:25-32. doi: 10.1016/j.arteri.2020.12.004.
The lipid theory of atherosclerosis dates back more than a century. Despite this, some authors have questioned the relevance of hypercholesterolaemia in its development. Multiple experimental, epidemiological, and clinical evidence underpins this association. Atherosclerotic cardiovascular disease remains as the major cause of mortality in the world. Recent genetic studies of Mendelian randomisation and randomised clinical trials aimed at LDL cholesterol reduction, are summarised in this article. They, unequivocally ratify the aetiological role of LDL cholesterol in the development of atherosclerosis. Thus, LDL cholesterol lowering is the cornerstone of lipid lowering therapy for the reduction of cardiovascular complications of atherosclerosis.
动脉粥样硬化的脂质理论可以追溯到一个多世纪以前。尽管如此，一些作者仍质疑高胆固醇血症在其发展中的相关性。大量的实验、流行病学和临床证据支持这种关联。动脉粥样硬化性心血管疾病仍然是世界上主要的死亡原因。本文总结了最近关于 LDL 胆固醇降低的孟德尔随机化和随机临床试验的遗传研究。它们明确证实了 LDL 胆固醇在动脉粥样硬化发展中的病因作用。因此，降低 LDL 胆固醇是降低动脉粥样硬化心血管并发症的降脂治疗的基石。
