LDL-C: The Level Matters, but So Does the Duration of Exposure

Authors

DOI:

https://doi.org/10.51987/Rev.Hosp.Ital.B.Aires.v46i4.1385

Keywords:

Cholesterol, LDL, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Atherosclerosis, Cardiovascular Risk Factors, Controversy

Abstract

Should statin therapy be recommended for a healthy young adult with persistently elevated LDL cholesterol levels? The editors of the Revista del Hospital Italiano de Buenos Aires invite readers to reflect on this debated topic through a hypothetical clinical scenario.

Dr. Walter Masson presents his arguments regarding the use of cholesterol-lowering pharmacological treatment in young adults with low short-term cardiovascular risk and discusses the factors that should be considered when making this decision.

Read also Dr. Karin Kopitowski’s commentary [link].

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References

Cholesterol Treatment Trialists’ (CTT) Collaboration; Baigent C, Blackwell L, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376(9753):1670-1681. https://doi.org/10.1016/S0140-6736(10)61350-5 DOI: https://doi.org/10.1016/S0140-6736(10)61350-5

Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of dyslipidemia: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2026;87(19):2624-2757. https://doi.org/10.1016/j.jacc.2025.11.016 DOI: https://doi.org/10.1016/j.jacc.2025.11.016

Zheutlin AR, Handoo F, Luebbe S, et al. Cumulative exposure to atherogenic lipoprotein particles in young adults and subsequent incident atherosclerotic cardiovascular disease. Eur Heart J. 2025;46(41):4302-4312. https://doi.org/10.1093/eurheartj/ehaf472 DOI: https://doi.org/10.1093/eurheartj/ehaf472

Domanski MJ, Tian X, Wu CO, et al. Time course of LDL cholesterol exposure and cardiovascular disease event risk. J Am Coll Cardiol. 2020;76(13):1507-1516. https://doi.org/10.1016/j.jacc.2020.07.059 DOI: https://doi.org/10.1016/j.jacc.2020.07.059

Stone NJ, Smith SC Jr, Orringer CE, et al. Managing atherosclerotic cardiovascular risk in young adults: JACC state-of-the-art review. J Am Coll Cardiol. 2022;79(8):819-836. https://doi.org/10.1016/j.jacc.2021.12.016 DOI: https://doi.org/10.1016/j.jacc.2021.12.016

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Published

2026-11-06

Data Availability Statement

Not applicable.

How to Cite

1.
Masson W. LDL-C: The Level Matters, but So Does the Duration of Exposure. Rev Hosp Ital B.Aires [Internet]. 2026 Nov. 6 [cited 2026 Nov. 7];46(4):e0001385. Available from: https://ojs.hospitalitaliano.org.ar/index.php/revistahi/article/view/1385

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