In the United States, cardiovascular diseases account for about 1 of every 3 deaths.[1] The cornerstone in heart disease treatment is reducing elevations of LDL, popularly known as the “bad cholesterol” (see table below “What do the terms mean?”) [2, 3], primarily with statins, the most widely used cholesterol/ heart disease drug.[4]  

 

However, when one looks at the aggregate effectiveness of statin treatment in all studies, morbidity and mortality rates among statin-treated patients still remain approximately two thirds to three quarters of those found in patients randomized to placebo.[5, 6] In the “Treating to New Targets” study there were still 80% cases of cardiovascular disease, despite intensive treatment with high-dose statins.[7]

 

Thus, many patients – even those treated aggressively with statins to meet LDL goals - have residual cardiovascular risk.[8-13] This remaining risk is associated with low levels of HDL, increased levels of triglycerides, and elevated numbers of small, dense, atherogenic LDL particles.[8, 10, 11, 14-17] and other common metabolic abnormalities that you will find out about in this article...