[Prevention of cardiovascular diseases by intervention in lipid metabolism].

Atherogenesis is a multifactorial event. Experimental, clinical and epidemiological studies, however, have clearly indicated the major role of LDL-cholesterol in the process of cholesterol deposition in the arterial wall. Although most patients with severe hypercholesterolemia suffer from premature coronary heart disease, it is a medical experience, that there are subjects who tolerate hypercholesterolemia and reach high ages without problems of their coronary arteries. Thus, there is much biological variation in the response of the arterial wall to elevated LDL-cholesterol, a fact which emphasizes the need to differentiate between goals and means of primary and the goals and means of secondary prevention of coronary heart disease and between the goals of a population strategy and the goals and means of an individual therapeutic strategy. Today the knowledge about the role of lipids and lipoproteins in atherogenesis is convincing. Epidemiological as well as intervention studies have proven the benefit of an appropriate lipid lowering therapy.