THE FUTURE OF CARDIOVASCULAR-DISEASE PREVENTION AND THE ROLE OF LIPIDREGULATION

CVD continues to be the major health problem in developed countries, e specially in the aging population. Targeted prevention is likely to re duce CVD morbidity and mortality. Epidemiological and experimental evi dence link the more common dyslipidemias (especially high total- and L DL-cholesterol levels or low HDL-chlolesterol levels) to the increased risk of developing CVD. CVD prevention involves, besides correction o f risk factors such as plasma lipids, direct pharmacological control o f the pathogenic processes occurring within the arterial wall. Thus, c orrection of lipid alterations pro: duces a multiple-steps antiatheros clerotic effect on the Vessel wall and clotting system. Some of these positive effects (i.e., on endothelial function, smooth muscle cell ab normal proliferation, machrophage activation, and clotting system) may actually antedate beneficial changes in atherosclerotic plaque stabil ization and/or regression.