Lipids & Atherosclerotic CVD
Dyslipidaemia is one of the most important modifiable risk factors for atherosclerotic cardiovascular disease, and atherosclerosis remains the leading cause of cardiovascular morbidity and mortality worldwide. Metabolic disorders accelerate both.
Lipids drive plaque; metabolism accelerates it.
Advances in lipid biology, cardiovascular research and lipid-lowering therapies have transformed the prevention and treatment of atherosclerotic disease. Beyond LDL cholesterol, attention now extends to triglyceride-rich lipoproteins, remnant cholesterol, non-HDL cholesterol, apolipoprotein B and lipoprotein(a).
Diabetes, obesity, insulin resistance and metabolic syndrome produce a characteristic atherogenic dyslipidaemia and contribute to endothelial dysfunction, inflammation and accelerated plaque development. Understanding these links is essential for effective primary and secondary prevention.
IMACH promotes evidence-based lipid management with a focus on individual cardiovascular risk, treatment targets and the long-term reduction of atherosclerotic events — encouraging collaboration between metabolic and cardiovascular specialists.
Key areas of scientific focus
Lipid management
- LDL cholesterol targets and treatment strategies
- Atherogenic dyslipidaemia in metabolic disorders
- Hypertriglyceridaemia and triglyceride-rich lipoproteins
- Lipoprotein(a), ApoB and residual cardiovascular risk
- Familial hypercholesterolaemia
- Statins, ezetimibe, PCSK9-directed and newer therapies
Atherosclerosis
- Atherosclerosis pathophysiology and inflammation
- Endothelial dysfunction
- Coronary artery disease in diabetes and metabolic syndrome
- Peripheral arterial disease
- Stroke and cerebrovascular disease
- Cardiovascular risk assessment and imaging
Prevention & special groups
- Primary and secondary cardiovascular prevention
- Lipid management in diabetes and CKD
- Premature cardiovascular disease in young adults
- Dyslipidaemia in women and older adults
- Lifestyle and nutritional lipid therapy
- Long-term adherence and monitoring
Clinical challenges we address
Under-treatment
A large proportion of high-risk patients do not reach LDL targets.
Missed genetic risk
Familial hypercholesterolaemia and elevated Lp(a) remain heavily under-diagnosed.
Residual risk
Events continue despite statin therapy; additional strategies are often needed.
Statin hesitancy
Perceived side-effects and misinformation reduce long-term adherence.
Silent disease
Subclinical atherosclerosis frequently goes unrecognised until an event.
Early-onset disease
Premature coronary disease is a growing concern in younger metabolic patients.
Translating evidence into everyday care
IMACH programmes focus on applying guideline-based risk categories and lipid targets, choosing combination therapy early where appropriate, and using imaging and biomarkers judiciously.
A practical approach to lipid care:
| Care stage | Focus for clinicians |
|---|---|
| Measure | Full lipid profile, non-HDL-C; consider ApoB and Lp(a) at least once. |
| Stratify | Assign cardiovascular risk category; identify FH and metabolic drivers. |
| Treat to target | Lifestyle plus high-intensity statin; add ezetimibe or other agents as required. |
| Address residual risk | Triglycerides, Lp(a), inflammation, blood pressure and glucose. |
| Sustain | Monitoring, adherence support and periodic reassessment. |
IMACH programmes in this area
Lipid clinic training
Practical lipid management, from screening to advanced therapy.
FH detection initiative
Awareness of familial hypercholesterolaemia and cascade screening.
Atherosclerosis imaging updates
Role of calcium scoring and vascular imaging.
Residual risk symposia
Beyond LDL: triglycerides, Lp(a) and inflammation.
Secondary prevention workshops
Post-event care, adherence and rehabilitation.
Case reviews
Statin intolerance, very high-risk and premature disease.
Who this area brings together
Preventing atherosclerotic events requires cardiologists, metabolic physicians, primary care and nutrition experts working from a shared plan.
Questions we explore
- How can more high-risk patients reach LDL targets?
- When should Lp(a) and ApoB be measured, and what changes as a result?
- How should atherogenic dyslipidaemia in diabetes be managed?
- What role does imaging play in refining risk?
- How can statin adherence be improved over the long term?
Frequently asked questions
Why combine dyslipidaemia and atherosclerosis?
Lipids are the principal causal driver of atherosclerotic disease. Treating them together reflects the continuum from risk factor to clinical event.
Does IMACH cover familial hypercholesterolaemia?
Yes — detection, family screening and management of FH are part of this therapy area.
Is stroke included?
Yes, cerebrovascular disease is addressed as part of atherosclerotic cardiovascular disease.
This page is intended for healthcare professionals and is educational in nature. It does not constitute medical advice or treatment recommendations for individual patients. Clinical decisions should follow current guidelines, local regulations and individual patient assessment.
Contribute to lipid and atherosclerosis care at IMACH.
Join as a member, faculty or research collaborator in this therapy area.