Lipoproteins and cardiovascular disease risk

Cardiovascular disease (CVD) risk assessment is complex, with lipoproteins constituting a key part of any prediction algorithm. In addition to circulating lipoprotein fractions, an individual's CVD risk is also influenced by the concomitant presence or absence of other standard CVD risk factors. In this chapter, we describe the strengths and weaknesses of common circulating lipoproteins that are measured in clinical practice for predicting CVD risk. We also discuss how risk assessment tools utilize lipoprotein values in the general assessment of global CVD risk. We highlight the differences between various guidelines for the management of dyslipidemia specifically related to the measurement of select apolipoproteins for assessing CVD risk, comparing the recommendations from Europe, Canada, and the USA. In the end, we elucidate the concept of "residual risk" that accrues from not reaching the target goals for individual lipoprotein concentrations when all other modifiable risk factors are well controlled.