Editorial [Hot Topic:Lipid Lowering Agents (Guest Editor: John W. Clader)]

In the closing days of 2004, the American Heart Association released its annual statistics on heart disease and stroke (http: / / www.americanheart.org). To the surprise of no one, these data showed that cardiovascular disease remains the leading cause of death in the US, claiming over 900,000 lives in 2002. The direct and indirect costs of cardiovascular disease are estimated to reach $393 billion in 2005. Almost as disturbing as the size of the problem is the realization that the situation persists in the face of all that has been done to understand and treat this disease. Despite decades of research, tremendous advances in treatment and prevention, and a broad-based public awareness campaign on the risk factors for cardiovascular disease, Americans continue to die from coronary events at the rate of about one every 34 seconds. The epidemic of cardiovascular disease is not limited to the United States. The WHO estimates that worldwide 17 million people die every year from cardiovascular disease, especially heart attack and stroke (http: / / www.who.int). Of the many risk factors for cardiovascular disease, dyslipidemia is among the best understood and one that has clearly lent itself to both life-style and pharmacological intervention. Several large clinical studies conducted over the last few decades have indicated that overall mortality rates from cardiovascular disease can be significantly reduced with aggressive pharmacological intervention and risk factor management. If the prevalence of cardiovascular disease is no surprise, then it should be equally understandable that drugs that lower cholesterol and triglyceride levels are consistently at the top of global pharmaceutical sales. That death from this disease remains at such a staggering level attests to the need for more to be done. This issue of Current Topics in Medicinal Chemistry highlights several areas of current interest in the area of lipid modulation for the possible treatment and prevention of cardiovascular disease. Clearly a problem of this magnitude demands an intensive and multi-pronged attack, and a single volume can hardly do justice to the area, even if restricted to drugs affecting lipids. The topics for this volume were chosen to at least sample the range of approaches from the latest in established lipid lowering therapies, through the newest approaches that have been approved recently or may be available in the next few years, and ending with a brief glimpse of things that may be on the more distant horizon.