2008, Volume 15, Supplement 2: Cholesterol management

The management of cardiovascular risk is a huge area for debate, involving a multitude of factors, disciplines and guidelines. The Cardiodiabetes Forum, sponsored by MSD Ltd and Schering-Plough Ltd, was a multidisciplinary meeting of diabetologists, cardiologists, and clinicians with particular interest in lipid and cardiovascular disease management who came together at the Royal College of Physicians in London to discuss some of the current hot topics in cardiovascular risk management in a series of five ‘round table’ style debates. Each debate was led by a member of the faculty; areas for consideration included the translation of cholesterol guidelines into practice, the use of new and existing surrogate markers, the management of risk in ‘at-risk’ populations and the need for a more collaborative approach in the management of diabetic patients with cardiovascular disease. Each group had a series of questions to address to give the debate some structure, but the content and areas discussed were largely dictated by the participants....

Current guidelines for primary and secondary prevention of CVD...

What is a surrogate end point? Research, particularly intervention trials, can only be appropriately interpreted with pre-defined end points. The hypothesis being tested will be either proven or disproven by comparing the occurrence of the defined end points in the intervention and comparator groups. ‘Hard’ clinical end points are definable, identifiable and clinically important outcomes that directly reflect states of health, disease and illness. ...

Diabetes is a known, independent, risk factor for cardiovascular disease and since diabetes and serious cardiovascular disease are frequently observed together, the term ‘cardiodiabetes’ is increasingly applied to describe the convergence of these conditions....

New biomarkers, with the potential to serve as indicators of cardiovascular risk, are continually emerging. The validity of several of these was examined by this round table Group, who assessed the merits of biomarkers as additions or replacements to those markers currently in clinical use. ...

Cardiovascular risk assessment is currently very topical, with much debate about measurement and targets. Recent guidelines from the National Institute for Health and Clinical Excellence (NICE) on modification of blood lipids have provided helpful advice.(1)...