Postprandial hyperlipidemia and atherosclerosis

Abstract

Introduction In the past few decades, numerous clinical trials have established the efficacy of lowering low-density lipoprotein cholesterol (LDL-C) for the prevention of coronary heart disease (CHD). Although the incidence of CHD is significantly lower in Japan than in the United States or Europe, the MEGA study [1] (a Japanese clinical trial with approximately 4000 patients in each arm undergoing treatment with diet alone or diet plus pravastatin) has shown that treatment with a statin significantly reduces the incidence of CHD by 33%. Most clinical trials, including the MEGA study, show that LDL-lowering therapy with a statin reduces the incidence of CHD by almost 30%, meaning that statin therapy is not effective for the remaining 70% of hypercholesterolemic patients. Thus, it is necessary to discover effective intervention strategies other than LDL lowering with statins in order to achieve greater reduction in CHD rates.