Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Show Summary Details
Page of

Lipids and cardiovascular disease 

Lipids and cardiovascular disease
Chapter:
Lipids and cardiovascular disease
Author(s):

Dr Adie Viljoen

and Anthony Wierzbicki

DOI:
10.1093/med/9780199594764.003.0002
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 25 October 2020

Atherosclerotic plaques were noted to contain waxy deposits (cholesterol) by Fallopius in 1575 and in 1914 Anitschkow showed that cholesterol feeding led to atherosclerosis in a rabbit. The results of early lipid- lowering trials such as the Coronary Drug Project (clofibrate; niacin; d-thyroxine and oestrogen), World Health Organization Clofibrate Trial, Lipid Research Clinics (cholestyramine), and Programme on Surgical Correction of Hyperlipidaemia (ileal bypass surgery) were unclear, with some therapies showing no benefit (d-thyroxine and oestrogen) and the rest giving reductions in cardiovascular disease (CVD) events but not total mortality within the trial period. In some cases, for instance with clofibrate, mortality increased. Later trials (e.g. Helsinki Heart Study) failed to clarify the situation. A cholesterol controversy arose stating that cholesterol reduction might reduce CVD but increase other causes of mortality. The identity of the LDL-receptor was clarified and a class of drugs designed to block the rate-limiting step in cholesterol synthesis (2-hydroxy-methyl-glutaryl (HMG)-CoA reductase inhibitors) and increase LDL clearance was discovered. It remained to determine what their effects were in clinical practice.

A landmark paper in this field should fundamentally influence medical practice by setting a new paradigm for diagnosis, treatment, or by defining audit standards for the effectiveness of diagnosis or treatment so that improvements in care can be introduced and managed equitably.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.