Editor's Correspondence |

The Key to Atherogenicity

Scott M. Grundy, MD, PhD
Arch Intern Med. 1998;158(10):1157-1158. doi:.
Text Size: A A A
Published online


In reply

In response to my previous article,1 Serjeant questions my contention that elevated levels of serum low-density lipoprotein (LDL) play a central role in the pathogenesis of coronary heart disease (CHD) and that the primary mechanism whereby statin drugs reduce risk for CHD is by decreasing levels of LDL.

That elevated serum concentrations of total cholesterol and LDL cholesterol are necessary for atherogenesis and the development of CHD is based on evidence from epidemiological studies, genetic forms of hypercholesterolemia, animal models, laboratory investigations, and clinical trials.2 Populations that have very low levels of LDL do not have substantial rates of CHD even when other risk factors, such as hypertension, cigarette smoking, and diabetes, are common. Serjeant's claim that most patients with CHD have normal serum levels of LDL is no longer tenable. What used to be considered normal is now considered too high and can be atherogenic.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





May 25, 1998
Scott M. Grundy, MD, PhD
Arch Intern Med. 1998;158(10):1157-1158. doi:.
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles

Users' Guides to the Medical Literature
Statin Dosing and LDL Levels

Users' Guides to the Medical Literature
Using the Guide