Even below LDL-c target (<70 mg/dL), further LDL-c reduction gives additional CV benefit
Over time, lower LDL-c levels have been achieved in lipid-lowering trials evaluating different LDL-c lowering strategies. These LDL-c reductions are consistently associated with lower CV risk, also at levels below currently recommended LDL-c targets. A positive dose-response relationship between CV event rate reduction and achieved LDL-c emerges when data from multiple LDL-c lowering trials in primary and secondary prevention setting are plotted together. There is no evidence for a U-shaped curve, thus low LDL-c levels do not infer greater CV risk. Even in patients with very low LDL-c (<0.26 mmol/L or <10 mg/dL) cardiovascular efficacy has been described, thus these patients still benefit from treatment as their risk of CV events is lowered by lipid-lowering therapy.