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(Circulation. 1997;95:1347-1348.)
© 1997 American Heart Association, Inc.

Articles

New Views on the Relationship of Plasma Lipids to Cardiovascular Disease

Russell P. Tracy, PhD; Paula B. Tracy, PhD

the Departments of Pathology (R.P.T.), Biochemistry (R.P.T., P.B.T.), and Medicine (P.B.T.), University of Vermont, Burlington.

Correspondence to Dr R.P. Tracy, Department of Pathology, University of Vermont, 55A South Park Dr, Colchester, VT 05446. E-mail rtracy@moose.uvm.edu

Key Words: Editorials • thrombosis • lipoproteins • platelets • lipids

	Introduction

 
In this issue, Nofer et al¹ report on a possible new mechanism that may help explain the relationship between plasma lipids and cardiovascular disease (CVD). New views on "established" relationships are always welcome and frequently important. Data supporting the general relationship of plasma lipids and CVD are extensive. The important contributions of Keys and colleagues in the Seven Countries Study^{2 3} as well as other multipopulation studies^{4 5 6} clearly established that higher saturated fat and cholesterol in the diet were associated with a greater incidence of CVD. Major epidemiological studies such as the Framingham Study⁷ established the risk relationship that exists between plasma lipid levels and CVD.

A large body of evidence, including work in animal models and human clinical trials, has established that plasma lipids play a causal role in atherosclerotic CVD. Our belief in causality has resulted in a national effort to document the plasma cholesterol concentrations in healthy individuals and modify them when appropriate under the guidelines prepared by the National Cholesterol Education Panel.⁸ These guidelines take into account the probable harmful effects of LDL particles and beneficial effects of HDL particles but do not address any possible effects of fasting or postprandial VLDL particles, because data on this topic have been difficult to obtain.

The exact mechanism by which plasma lipids exert this "causal" effect has been the subject of intense research over the past two to three decades. As is always the case when we try to establish exact mechanisms in complex biological systems, this search is . . . [Full Text of this Article]