Risk factors and prevention, including hyperlipidemias

Cardiovascular disease is the leading cause of death in the United States for both men and women (1). However, great strides have been made in the field of preventive cardiology over the past decade, that, combined with the significant advances in revascularization technologies, have enhanced the clinician's ability to manage patients across the spectrum of atherosclerosis, from subclinical coronary heart disease (CHD) to congestive heart failure. Additionally, advances in noninvasive and invasive imaging have improved the capacity to diagnose the presence and vulnerability of the atherosclerotic plaque. Hypertension, smoking, and dyslipidemia remain the major remediable risk factors for the development and progression of atherosclerosis. This chapter will briefly review the major risk factors for CHD, then place a special emphasis on the management of lipid disorders based on the 2001 iteration of guidelines from the US National Cholesterol Education Program (NCEP), which stress the management of low-density lipoprotein cholesterol (LDL-C) as the primary target of lipid therapy (2).