Decades of research have demonstrated that low-density lipoprotein cholesterol (LDL-C) is a causative factor in the development of atherosclerotic cardiovascular disease, and lipid-lowering therapy can dramatically reduce this risk. Yet exactly when to begin lipid-lowering therapy has not been well demarcated. Atherosclerotic lesions develop slowly over many years, if not decades. However, guidelines for lipid management have largely recommended statins on the basis of a 10-year risk of cardiovascular events rather than the risk of developing atherosclerosis over a lifespan. As a result, young adults (aged <40 years) are eligible for statins only if they have familial hyperlipidemia, severely elevated LDL-C level (>190 mg/dL; to convert to millimoles per liter, multiply by 0.0259) or LDL-C of 160 mg/dL or higher, and a family history of premature atherosclerotic cardiovascular disease.¹

数十年的研究表明，低密度脂蛋白胆固醇 (LDL-C) 是动脉粥样硬化性心血管疾病发展的致病因素，降脂治疗可以显着降低这种风险。然而，究竟何时开始降脂治疗尚未明确。动脉粥样硬化病变即使不是几十年，也会在多年内缓慢发展。然而，脂质管理指南主要基于 10 年心血管事件风险而非终生发生动脉粥样硬化的风险推荐他汀类药物。因此，只有患有家族性高脂血症、LDL-C 水平严重升高（>190 mg/dL；转换为毫摩尔/升，乘以 0.0259）或 LDL- C 160 mg/dL 或更高，¹