SCIENTIFIC JOURNAL of the Hungarian Society of Cardiology

Thoughts about plaques and lifelong lipid lowering therapy

█ Review

DOI: 10.26430/CHUNGARICA.2023.53.2.161

Márk László1, Barna István2, Kiss Róbert Gábor3
1Békés Megyei Központi Kórház, Pándy Kálmán Tagkórház, Kardiológia Osztály, Gyula
2Semmelweis Egyetem, Belgyógyászati és Onkológiai Klinika, Budapest
3Északpesti-Centrumkórház/Honvédkórház, Kardiológiai Osztály, Budapest
Levelezési cím:
Prof. dr. Márk László, e-mail:


The majority of deaths occur due to atherosclerosis and related diseases, therefore the fight against it is one of the most important tasks of the medicine. Remarkable results have been achieved in the treatment of acute coronary syndrome, in the cardiovascular prevention, but the public health importance of this group of diseases remains enormous. There are general guidelines for the prevention of atherosclerosis (healthy diet, regular physical activity). The role of a healthy lifestyle in prevention is underlined by the fact that by following it, the cardiovascular risk determined by genetic tests could be reduced by 46%.

On individual level, the intensity of the prevention activity is determined by the absolute risk and risk category. The latter is often based on the results of 10 years risk score, which often is not suitable for characterizing the patient’s lifetime risk, and this is particularly typical for those under 40, but even for those aged 40–49. Therefore, recently much attention has been paid for the improvement of the accuracy of risk estimation. Such a possibility is the use of the polygenic risk score. It is also known that acute vascular events do not always occur on the plaques that cause the greatest stenosis. Newer examination possibilities bring us ever closer to finding vulnerable plaques in time and widely, but until this and the use of polygenic risk scores become part of the daily routine, we must use our available preventive tools according to the guidelines. Among them, our greatest backlog is in lipid lowering therapy, and from this point of view, the acceptance and practical application of the concept of cumulative-LDL load would help us to significantly reduce the lifelong cardiovascular risk of our patients.


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