"in HIGH risk individuals" needs to be repeated. And for those medically not inclined, you shouold elaborate on who you mean.
I'd be happy to jump in here re: high risk individuals.
Since athersoclerotic disease remains the number one cause of death I guess we all are at risk. However in medicine we are aware that certain risk factors place one at greater than average risk. Here's what we know so far. These are the Primary Risk Factors:
Smoking
Diabetes
High Blood Pressure
Elevated Cholesterol
Family History.
Of these 5 "major risk factors" note that only Family History cannot be changed. The primary focus in my office every day as part of an "annual exam" is geared towards addressing the other 4 risk factors.
An interesting foot note is that due to superb advances in drug therapy a recent study showed that Family History, which has historically been felt to be the most serious risk factor may no longer be the life-breaker. In other words, if you have a family history of bad atherosclerosis (i.e. primary relatives with premature heart attacks, strokes, etc.) we used to think you were screwed. However now we know that if you don't smoke and treat your blood pressure, cholesterol and diabetes aggressively you eliminate the family history variable. This may not sound like much but this is HUGE in terms of number of lives saved.
Finally, there is "secondary" prevention. This refers to folks who wised up too late, i.e. AFTER they had a heart attack or event. This group, in addition to Blood PRessure and diabetes care and smoking cessation, may need to achieve even LOWER cholesterol levels than those seeking Primary prevention. The current data suggests this group needs to maintain LDL ("bad") cholesterol well below 100, while the primary group needs to shoot for 100 to 130.
I hope this answers your question.
maineman
