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Hyperlipidaemia and cardiovascular disease.

机译：高脂血症和心血管疾病。

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Without doubt we are entering an era of multiple risk reduction therapy to achieve reductions in cardiovascular disease (CVD) events. The purpose of this editorial is to highlight important themes in hyperlipidaemia and CVD. We review selected recent publications associated with the study of the metabolic syndrome, HDL, and LDL.The definitions, applications, and utility of the metabolic syndrome have been debated widely in the recent literature [1-3]. Metabolic syndrome, predicted to affect 25% of the US population, may also affect 30% of obese adolescents. Weiss and Caprio [4~.] identified high rates of previously unidentified impaired glucose tolerance and type 2 diabetes in obese children and adolescents. Further weight gain in these young people predicted progression to impaired glucose tolerance or type 2 diabetes. The investigators reported that the biomarkers of CVD were already present in these young people with metabolic syndrome. This finding may have major epidemiologic consequences for future health provision.Recent re-examination of the MIRACL trial (Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering) demonstrates that the presence of metabolic syndrome in patients with acute coronary syndrome increased the risk of early recurrent cardiovascular events (hazard ratio of 1.49, P < 0.0001). Cholesterol lowering with atorvastatin lowered the risk of recurrent ischaemic events to the same degree in subjects with and subjects without metabolic syndrome.It is clear that the metabolic syndrome is clinically useful for the identification of individuals at high risk of cardiovascular events, and targeting of risk reduction therapy in these individuals may result in lower cardiovascular event rates.
机译：毫无疑问，我们正在进入多重风险降低疗法的时代，以减少心血管疾病（CVD）事件。这篇社论的目的是突出高脂血症和CVD的重要主题。我们回顾了与代谢综合征，HDL和LDL研究相关的近期出版物。在最近的文献中，关于代谢综合征的定义，应用和效用已进行了广泛的辩论[1-3]。代谢综合症预计会影响美国25％的人口，也可能会影响30％的肥胖青少年。 Weiss和Caprio [4]在肥胖儿童和青少年中发现了以前未发现的糖耐量降低和2型糖尿病的高发病率。这些年轻人中体重的进一步增加预示着糖耐量下降或2型糖尿病的进展。研究人员报告说，这些患有代谢综合征的年轻人中已经存在CVD的生物标志物。这一发现可能对将来的健康提供重大的流行病学后果。MIRACL试验的最新复查（降低胆固醇并降低胆固醇的心肌缺血）表明，急性冠状动脉综合征患者体内代谢综合征的存在增加了早期复发心血管事件的风险（危险比1.49，P <0.0001）。阿托伐他汀降低胆固醇可将患有或未患有代谢综合征的受试者复发性缺血事件的风险降低至相同程度。显然，代谢综合征在临床上可用于识别心血管事件高风险的个体并确定风险目标在这些个体中进行降压治疗可能会降低心血管事件的发生率。

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