The session started with the presentation of Antonis Zampellas (Athens, Greece) on “Lipids and diet – all the clinicians need to know”. He discussed the importance of the Mediterranean diet on improving total cholesterol/HDL cholesterol ratio, increasing HDL levels as well as systolic and diastolic blood pressure, glucose and inflammatory markers. He also stressed the role of omega-3 fatty acids from fishes which cause appearance of less dense and less atherogenic LDL particles in blood which might be an explanation for n less non fatal and fatal MIs. He also discussed the role of trans-fatty acids in food and supported this with the example of the Netherlands where reduction in consumption of trans-fatty acids caused a significant decrease of cardiovascular deaths.
SM Jovinge (Lund, Sweden) was talking on “Lipids, inflammation and atherosclerosis – cause or effect” presenting an overview of basic and clinical research on this topics. He also addressed the question of patients with rheumatic diseases who receive the treatment affecting immune mechanisms and therefore having less cardiovascular end-points.
John Chapman (Paris, France) in his presentation “Optimising lipid profiles with new drugs – what can we achieve?” after presenting the effects of statins and other drugs affecting LDL metabolism, suggested that lowering total and LDL cholesterol can not abolish the majority of CHD risk. Therefore, low HDL has to be addressed too. However, the point is not only in increasing HDL level in blood but affecting its metabolism. This is at the moment in the focus of interest and the possibilities of doing this with PG inhibitors (MK-0524 A/B), CETP inhibitors, apo AI mimetics, PPAR beta/delta and PPAR alpha/gamma agonists, FXR,LXR agonists and Apo AI and ABCAI agonists, are investigated.
The last presentation was by Terje Pedersen (Oslo, Norway) entitled “Recent trials with lipid lowering drugs – will they really change clinical practice?” who gave an excellent overview of all the recent lipid-lowering trials as well as those ongoing and discussed how these trials have affected the everyday clinical practice. An illustration might be the data on statin sales – in 1994 1 billion dollars (before 4S trial) and today around 30 billion dollars.