Skip to main content
Have a personal or library account? Click to login
Cholesterol: Facts and Opinions by a Non-lipid Cardiologist Cover

Cholesterol: Facts and Opinions by a Non-lipid Cardiologist

By:   
Open Access
|Sep 2026

References

  1. Ference BA, Ginsberg HN, Graham I, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017 Aug 21;38(32):2459-2472. doi: 10.1093/eurheartj/ehx144
  2. Borén J, Chapman MJ, Krauss RM, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2020 Jun 21;41(24):2313-2330. doi: 10.1093/eurheartj/ehz962
  3. Ross R. Cell biology of atherosclerosis. Annu Rev Physiol. 1995;57:791-804. doi: 10.1146/annurev.ph.57.030195.004043
  4. Assimes TL, Roberts R. Genetics: Implications for Prevention and Management of Coronary Artery Disease. J Am Coll Cardiol. 2016 Dec 27;68(25):2797-2818. doi: 10.1016/j.jacc.2016.10.039
  5. Erdmann J, Kessler T, Munoz Venegas L, Schunkert H. A decade of genome-wide association studies for coronary artery disease: the challenges ahead. Cardiovasc Res. 2018 July 15;114(9):1241-1257. doi: 10.1093/cvr/cvy084
  6. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005 Oct 8;366(9493):1267-1278. doi: 10.1016/S0140-6736(05)67394-1
  7. Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010 Nov 13;376(9753):1670-1681. doi: 10.1016/S0140-6736(10)61350-5
  8. Benjamin EJ, Virani SS, Callaway CW, et al. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018 Mar 20;137(12):e67-e492. doi: 10.1161/CIR.0000000000000558
  9. Murray CJL, Lopez AD. Measuring the global burden of disease New England journal of medicine 2013 Aug 1;369(5):448-457. doi: 10.1056/NEJMRA1201534
  10. Ray KK, Molemans B, Schoonen WM, et al. EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study. Eur J Prev Cardiol. 2021 Sep 20;28(11):1279-1289. doi: 10.1093/eurjpc/zwaa047
  11. De Backer G, Jankowski P, Kotseva K, et al. Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries. Atherosclerosis. 2019 Jun;285:135-146. doi: 10.1016/j.atherosclerosis.2019.03.014
  12. Dietrich E, Davis K. A Statin a Day to Keep the Doctor Away? Comparing Aspirin and Statins for Primary Prevention of Cardiovascular Disease. Ann Pharmacother. 2014 Sep;48(9):1238-1241. doi: 10.1177/1060028014540609
  13. Montgomery S, Miedema MD, Dodson JA. Aspirin and statin therapy for primary prevention of cardiovascular disease in older adults. Heart. 2022 Jun 24;108(14):1090-1097. doi: 10.1136/heartjnl-2021-320154
  14. Cohen DE. Balancing cholesterol synthesis and absorption in the gastrointestinal tract. J Clin Lipidol. 2008 Apr;2(2):Sl-S3. doi: 10.1016/j.jacl.2008.01.004
  15. Tabas I. Consequences of cellular cholesterol accumulation: basic concepts and physiological implications. J Clin Invest. 2002 Oct;110(7):905-911. doi: 10.1172/JCI16452
  16. Luo J, Yang H, Song BL. Mechanisms and regulation of cholesterol homeostasis. Nat Rev Mol Cell Biol. 2020 Apr;21(4):225-245. doi: 10.1038/s41580-019-0190-7
  17. Tabas I. Free cholesterol-induced cytotoxicity a possible contributing factor to macrophage foam cell necrosis in advanced atherosclerotic lesions. Trends Cardiovasc Med. 1997 Oct;7(7):256-263. doi: 10.1016/S1050-1738(97)00086-8
  18. Warner GJ, Stoudt G, Bamberger M, Johnson WJ, Rothblat GH. Cell toxicity induced by inhibition of acyl coenzyme A:cholesterol acyltransferase and accumulation of unesterified cholesterol. J Biol Chem. 1995 Mar 17;270(11):5772-5778. doi: 10.1074/jbc.270.11.5772
  19. Hegele RA. Plasma lipoproteins: genetic influences and clinical implications. Nat Rev Genet. 2009 Feb;10(2):109-121. doi: 10.1038/nrg2481
  20. Navar-Boggan AM, Peterson ED, D’Agostino RB Sr., Neely B, Sniderman AD, Pencina MJ. Hyperlipidemia in early adulthood increases long-term risk of coronary heart disease. Circulation. 2015 Feb 3;131(5):451-458. doi: 10.1161/CIRCULATIONAHA.114.012477
  21. Ference BA, Yoo W, Alesh I, et al. Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: a Mendelian randomization analysis. J Am Coll Cardiol. 2012 Dec 25;60(25):2631-2639. doi: 10.1016/j.jacc.2012.09.017
  22. Cannon CP, Blazing MA, Giugliano RP, et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med. 2015 Jun 18;372(25):2387-2397. doi: 10.1056/NEJMoa1410489
  23. Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med. 2017 May 4;376(18):1713-1722. doi: 10.1056/NEJMoa1615664
  24. Giugliano RP, Pedersen TR, Park JG, et al. Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial. Lancet. 2017 Oct 28;390(10106):1962-1971. doi: 10.1016/S0140-6736(17)32290-0
  25. Schwartz GG, Steg PG, Szarek M, et al. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. N Engl J Med. 2018 Nov 29;379(22):2097-2107. doi: 10.1056/NEJMoa1801174
  26. Amarenco P, Bogousslavsky J, Callahan A 3rd., et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006 Aug 10;355(6):549-559. doi: 10.1056/NEJMoa061894
  27. Silverman MG, Ference BA, Im K, et al. Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis. JAMA. 2016 Sep 27;316(12):1289-1297. doi: 10.1001/jama.2016.13985
  28. Marston NA, Giugliano RP, Park JG, et al. Cardiovascular Benefit of Lowering Low-Density Lipoprotein Cholesterol Below 40 mg/dL. Circulation. 2021 Nov 23;144(21):1732-1734. doi: 10.1161/CIRCULATIONAHA.121.056536
  29. Descamps OS, Bruniaux M, Guilmot PF, Tonglet R, Heller FR. Lipoprotein concentrations in newborns are associated with allelic variations in their mothers. Atherosclerosis. 2004 Feb;172(2):287-298. doi: 10.1016/j.atherosclerosis.2003.11.002
DOI: https://doi.org/10.14797/mdcvj.1826 | Journal eISSN: 1947-6108
Language: English
Page range: 22 - 27
Submitted on: Mar 17, 2026
Accepted on: May 15, 2026
Published on: Sep 15, 2026
Published by: Houston Methodist DeBakey Heart & Vascular Center
In partnership with: Paradigm Publishing Services

© 2026 Robert Roberts, published by Houston Methodist DeBakey Heart & Vascular Center
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.