Curing atherosclerosis should be the next major cardiovascular prevention goal
Open accessAbstract
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in developed and developing countries. Despite decades of effort, unhealthy lifestyle habits and ASCVD risk factor levels remain high and are increasing in many population groups. A new approach to ASCVD prevention is needed. Multiple lines of evidence from animal and human studies suggest that atherosclerosis regression and normalization of vessel function can occur when low-density lipoprotein cholesterol (LDL-C) lowering occurs early in the course of atherosclerosis or when very aggressive LDL-C lowering occurs somewhat later. We propose a new paradigm focused on curing atherosclerosis early in the course of the disease. An approach that resets the vascular aging clock composed of initial regression therapy followed by periodic retreatment to suppress atherosclerosis development may be possible, with the ultimate goal of preventing subsequent ASCVD events. Proof-of-concept studies are needed to determine: 1) the optimal age and/or extent of atherosclerosis for intervention and LDL-C-lowering therapy; 2) the intensity and duration of therapy for inducing atherosclerosis regression; and 3) documenting the normalization of vascular function. Ultimately, this new paradigm will need to be evaluated in ASCVD outcomes trials.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The duration of exposure to low LDL-C levels may be as important as the magnitude of LDL-C lowering.
“Additionally, increasing evidence also suggests that the duration of exposure to low LDL-C levels may be as important as the magnitude of LDL-C lowering [11][12][13][14][15][16].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
General Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study
D’Agostino, R. B., Vasan, R. S., Pencina, M. J., Wolf, P. A., Cobain, M., Massaro, J. M., & Kannel, W. B. (2008) · Circulation · doi:10.1161/circulationaha.107.699579 · Cited by 7,491 · see citing works
Stone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H., Goldberg, A. C., Gordon, D., Levy, D., Lloyd-Jones, D. M., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437738.63853.7a · Cited by 7,081 · see citing works
Self-citationRosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein
Ridker, P. M., Danielson, E., Fonseca, F. A. H., Genest, J., Gotto, A. M., Kastelein, J. J. P., Koenig, W., Libby, P., Lorenzatti, A. J., MacFadyen, J. G., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0807646 · Cited by 6,674 · see citing works
Cholesterol Treatment Trialists' (CTT) Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)61350-5 · Cited by 6,550 · see citing works
HEART DISEASE AND STROKE STATISTICS–2014 UPDATE: A REPORT FROM THE AMERICAN HEART ASSOCIATION
Tarver, T. (2014) · Journal of Consumer Health on the Internet · doi:10.1080/15398285.2014.902284 · Cited by 5,595 · see citing works
Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., Bravata, D. M., Dai, S., Ford, E. S., Fox, C. S., et al. (2013) · Circulation · doi:10.1161/cir.0b013e31828124ad · Cited by 5,292 · see citing works
Berenson, G. S., Srinivasan, S. R., Bao, W., Newman, W. P., Tracy, R. E., & Wattigney, W. A. (1998) · New England Journal of Medicine · doi:10.1056/nejm199806043382302 · Cited by 4,032 · see citing works
Rosuvastatin to Prevent Vascular Events in Men and Women With Elevated C-Reactive Protein
Ridker, P. M., Danielson, E., Fonseca, F. A. H., Genest, J. J., Gotto, A. M., Kastelein, J. J. P., Köenig, W., Libby, P., Lorenzatti, A. J., MacFadyen, J. G., et al. (2009) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000344393.60303.0a · Cited by 3,641 · see citing works
Biological, clinical and population relevance of 95 loci for blood lipids
Teslovich, T. M., Musunuru, K., Smith, A. V., Edmondson, A. C., Stylianou, I. M., Koseki, M., Pirruccello, J. P., Ripatti, S., Chasman, D. I., Willer, C. J., et al. (2010) · Nature · doi:10.1038/nature09270 · Cited by 3,487 · see citing works
Sequence Variations in <i>PCSK9,</i> Low LDL, and Protection against Coronary Heart Disease
Cohen, J. C., Boerwinkle, E., Mosley, T. H., & Hobbs, H. H. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa054013 · Cited by 3,181 · see citing works
Collaborators, C. T. T. (. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60367-5 · Cited by 2,833 · see citing works
Statins and risk of incident diabetes: A collaborative meta-analysis of randomised statin trials
Sattar, N., Preiss, D., Murray, H. M., Welsh, P., Buckley, B. M., de Craen, A. J., Seshasai, S. R. K., McMurray, J. J., Freeman, D. J., Jukema, J. W., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(09)61965-6 · Cited by 2,436 · see citing works
Kavey, R., Simons-Morton, D., & de Jesus, J. D. (2011) · Pediatrics · doi:10.1542/peds.2009-2107c · Cited by 2,131 · see citing works
Lifetime risks of cardiovascular disease
Berry, J. D., Dyer, A., Cai, X., Garside, D. B., Ning, H., Thomas, A., Greenland, P., Van Horn, L., Tracy, R. P., & Lloyd-Jones, D. M. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1012848 · Cited by 945 · see citing works
Ference, B. A., Yoo, W., Alesh, I., Mahajan, N., Mirowska, K. K., Mewada, A., Kahn, J., Afonso, L., Williams, K. A., & Flack, J. M. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.09.017 · Cited by 898 · see citing works
Effect of Two Intensive Statin Regimens on Progression of Coronary Disease
Nicholls, S. J., Ballantyne, C. M., Barter, P. J., Chapman, M. J., Erbel, R. M., Libby, P., Raichlen, J. S., Uno, K., Borgman, M., Wolski, K., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1110874 · Cited by 896 · see citing works
Ridker, P. M., Pradhan, A., MacFadyen, J. G., Libby, P., & Glynn, R. J. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61190-8 · Cited by 816 · see citing works
Crouse, J. R., Raichlen, J. S., Riley, W. A., Evans, G. W., Palmer, M. K., O’Leary, D. H., Grobbee, D. E., Bots, M. L., & for the METEOR Study Group (2007) · JAMA · doi:10.1001/jama.297.12.1344 · Cited by 708 · see citing works
(2012) · PsycEXTRA Dataset · doi:10.1037/e531652012-001 · Cited by 695 · see citing works
Efficacy and Safety of Statin Therapy in Children With Familial Hypercholesterolemia
Wiegman, A., Hutten, B. A., de Groot, E., Rodenburg, J., Bakker, H. D., Büller, H. R., Sijbrands, E. J. G., & Kastelein, J. J. P. (2004) · JAMA · doi:10.1001/jama.292.3.331 · Cited by 646 · see citing works
Mcgill, H., Mcmahan, C., & Gidding, S. (2008) · Circulation · doi:10.1161/circulationaha.107.717033 · Cited by 575 · see citing works
Self-citationEffect of statins on skeletal muscle function
Parker, B. A., Capizzi, J. A., Grimaldi, A. S., Clarkson, P. M., Cole, S. M., Keadle, J., Chipkin, S., Pescatello, L. S., Simpson, K., White, C. M., et al. (2013) · Circulation · doi:10.1161/circulationaha.112.136101 · Cited by 500 · see citing works
Neil, A., Cooper, J., Betteridge, J., Capps, N., McDowell, I., Durrington, P., Seed, M., Humphries, S. E., & on behalf of the Simon Broome Familial Hyperlipidaemia Register Group (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn422 · Cited by 425 · cited 1× · see citing works
“Notably, in longitudinal studies of young adults with FH, statin therapy initiated in adolescence was associated with a reduction in ASCVD events in young adulthood (29).”
BackgroundIntensification of Statin Therapy Results in a Rapid Reduction in Atherosclerotic Inflammation
Tawakol, A. A., Fayad, Z. A., Mogg, R., Alon, A., Klimas, M. T., Dansky, H. M., Subramanian, S. S., Abdelbaky, A., Rudd, J. H. F., Farkouh, M. E., et al. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.04.066 · Cited by 417 · see citing works
Long-term follow-up of the West of Scotland Coronary Prevention Study
Ford, I., Murray, H., Packard, C. J., Shepherd, J., Macfarlane, P. W., & Cobbe, S. M. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa065994 · Cited by 416 · see citing works
Pleiotropic Effects of Statins: Benefit Beyond Cholesterol Reduction?
Robinson, J. G., Smith, B., Maheshwari, N., & Schrott, H. G. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.05.085 · Cited by 407 · see citing works
Self-citationShay, C. M., Ning, H., Allen, N. B., Carnethon, M. R., Chiuve, S. E., Greenlund, K. J., Daviglus, M. L., & Lloyd-Jones, D. M. (2012) · Circulation · doi:10.1161/circulationaha.111.035733 · Cited by 368 · see citing works
Statin Treatment in Children With Familial Hypercholesterolemia
Rodenburg, J., Vissers, M. N., Wiegman, A., van Trotsenburg, A. S. P., van der Graaf, A., de Groot, E., Wijburg, F. A., Kastelein, J. J. P., & Hutten, B. A. (2007) · Circulation · doi:10.1161/circulationaha.106.671016 · Cited by 287 · see citing works
Changes in Plaque Lipid Content After Short-Term Intensive Versus Standard Statin Therapy
Kini, A. S., Baber, U., Kovacic, J. C., Limaye, A. M., Ali, Z. A., Sweeny, J. M., Maehara, A., Mehran, R., Dangas, G., Mintz, G. S., et al. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.03.058 · Cited by 283 · see citing works
Effects of Nonlipid Risk Factors on Atherosclerosis in Youth With a Favorable Lipoprotein Profile
McGill, H. C., McMahan, C. A., Zieske, A. W., Malcom, G. T., Tracy, R. E., & Strong, J. P. (2001) · Circulation · doi:10.1161/01.cir.103.11.1546 · Cited by 262 · see citing works
Hsia, J., MacFadyen, J. G., Monyak, J., & Ridker, P. M. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.09.082 · Cited by 231 · see citing works
Steinberg, D. H. (2004) · Journal of Lipid Research · doi:10.1194/jlr.r400003-jlr200 · Cited by 202 · see citing works
Rapid regression of atherosclerosis: insights from the clinical and experimental literature
Williams, K. J., Feig, J. E., & Fisher, E. A. A. (2008) · Nature Clinical Practice Cardiovascular Medicine · doi:10.1038/ncpcardio1086 · Cited by 188 · see citing works
Status of Cardiovascular Health in US Adolescents
Shay, C. M., Ning, H., Daniels, S. R., Rooks, C. R., Gidding, S. S., & Lloyd‐Jones, D. M. (2013) · Circulation · doi:10.1161/circulationaha.113.001559 · Cited by 183 · see citing works
Self-citationLipid and Inflammatory Cardiovascular Risk Worsens Over 3 Years in Youth With Type 2 Diabetes
TODAY Study Group (2013) · Diabetes Care · doi:10.2337/dc12-2388 · Cited by 152 · see citing works
Reduction in Blood Pressure With Statins Results From the UCSD Statin Study, a Randomized Trial
Golomb, B. A. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.7.721 · Cited by 145 · see citing works
Sever, P., Chang, C. L., Gupta, A. K., Whitehouse, A., & Poulter, N. R. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr333 · Cited by 124 · see citing works
Stabilization of atherosclerotic plaques: an update
Ylä‐Herttuala, S., Bentzon, J. F., Daemen, M. J. A. P., Falk, E., García‐García, H. M., Herrmann, J., Hoefer, I. E., Jauhiainen, S., Jukema, J. W., Krams, R., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht301 · Cited by 121 · see citing works
Gidding, S. S. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.21.2341 · Cited by 97 · see citing works
Self-citationWeinstock, R. S., Caprio, S., Copeland, K. C., Gidding, S. S., Hirst, K., Katz, L. L., Marcovina, S. M., Nadeau, K. J., & Nathan, D. M. (2013) · Diabetes Care · Cited by 95 · see citing works
Self-citationQuantifying Options for Reducing Coronary Heart Disease Mortality By 2020
Huffman, M. D., Lloyd‐Jones, D. M., Ning, H., Labarthe, D. R., Guzman-Castillo, M., O’Flaherty, M., Ford, E. S., & Capewell, S. (2013) · Circulation · doi:10.1161/circulationaha.112.000769 · Cited by 64 · see citing works
McMahan, C. A., McGill, H. C., Gidding, S. S., Malcom, G. T., Newman, W. P., Tracy, R. E., & Strong, J. P. (2006) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2006.02.008 · Cited by 59 · see citing works
Self-citationCausal Relevance of Blood Lipid Fractions in the Development of Carotid Atherosclerosis
Shah, S. H., Casas, J. P., Drenos, F., Whittaker, J. C., Deanfield, J. E., Swerdlow, D. I., Holmes, M. V., Mika Kivimaki, B., Langenberg, C., Wareham, N. J., et al. (2012) · Circulation Cardiovascular Genetics · doi:10.1161/circgenetics.112.963140 · Cited by 45 · see citing works
Impacts of age on coronary atherosclerosis and vascular response to statin therapy
Nozue, T., Yamamoto, S., Tohyama, S., Fukui, K., Umezawa, S., Onishi, Y., Kunishima, T., Sato, A., Nozato, T., Miyake, S., et al. (2013) · Heart and Vessels · doi:10.1007/s00380-013-0387-1 · Cited by 29 · see citing works
Nozue, T., Yamamoto, S., Tohyama, S., et al. (2012) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.12.016 · Cited by 27 · see citing works
Vascular Function During Prolonged Progression and Regression of Atherosclerosis in Mice
Miller, J. D., Chu, Y., Castaneda, L. E., Serrano, K. M., Brooks, R. M., & Heistad, D. D. (2013) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.112.252700 · Cited by 21 · see citing works
Emerging low-density lipoprotein therapies: Targeting PCSK9 for low-density lipoprotein reduction
Davidson, M. H. (2013) · Journal of clinical lipidology · doi:10.1016/j.jacl.2013.03.004 · Cited by 18 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Robinson and Gidding JACC Vol. 63, No. 25, 2014 Curing Atherosclerosis July 1, 2014:2779-85
Cited by
Sorted by citations
Wiegman, A., Gidding, S. S., Watts, G. F., Chapman, M. J., Ginsberg, H. N., Cuchel, M., Ose, L., Averna, M., Boileau, C., Borén, J., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv157 · Cited by 891 · see citing works
Self-citationNational Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2
Jacobson, T. A., Maki, K. C., Orringer, C. E., Jones, P. H., Kris-Etherton, P., Sikand, G., La Forge, R., Daniels, S. R., Wilson, D. P., Morris, P. B., et al. (2015) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2015.09.002 · Cited by 784 · see citing works
Wang, N., Fulcher, J., Abeysuriya, N., Park, L., Kumar, S., Di Tanna, G. L., Wilcox, I., Keech, A., Rodgers, A., & Lal, S. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30388-2 · Cited by 187 · see citing works
Hegele, R. A., Gidding, S. S., Ginsberg, H. N., McPherson, R., Raal, F. J., Rader, D. J., Robinson, J. G., & Welty, F. K. (2015) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/atvbaha.115.306442 · Cited by 63 · see citing works
Self-citationKasliwal, R. R., Bansal, M., Gupta, R., Shah, S., Dani, S., Oomman, A., Pai, V., Prasad, G. M., Singhvi, S., Patel, J., et al. (2016) · Nutrition · doi:10.1016/j.nut.2016.01.012 · Cited by 17 · see citing works
- Authors
- Robinson, J. G., & Gidding, S. S.
- Affiliations
- University of Iowa (US)
- Alfred I. duPont Hospital for Children (US)
- Corresponding author
- Robinson, Jennifer G.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 63
- Issue
- 25
- Pages
- 2779-2785
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2064407018
- Cited by
- 87
- References
- 48
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 6 · 2021: 5 · 2020: 7 · 2019: 9 · 2018: 11 · 2017: 8 · 2016: 13 · 2015: 19 · 2014: 5
- FWCI
- 14.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Amgen
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Sanofi
- Regeneron Pharmaceuticals
- Amarin Corporation
- Daiichi-Sankyo
- Esperion Therapeutics
- Genentech
- National Institute of General Medical Sciences (U54GM104941)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- atherosclerosis regression, atherosclerotic cardiovascular disease prevention, LDL cholesterol lowering, vascular aging, retreatment, early intervention, cardiovascular risk factors
- MeSH terms
- Cardiovascular Agents, Decision Making, Humans, Primary Prevention, Atherosclerosis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
