Cardiovascular diseases cause 18 million deaths per year globally and a similar number of nonfatal cardiovascular eventsElevated low-density lipoprotein (LDL) cholesterol levels account for approximately half the population-attributable risk of myocardial infarction and approximately one quarter of the risk of ischemic stroke.In previous trials, lowering LDL cholesterol levels with statins has been shown to reduce the risk of cardiovascular diseases, but most of the patients enrolled in those trials had vascular disease, elevated lipid levels, elevated inflammatory markers, hypertension, or diabetes. The association between LDL cholesterol level and cardiovascular disease is graded and has no documented threshold.Although 80% of the global burden of cardiovascular disease occurs in low- and middle-income countries, the majority of trials have been conducted in North America or Europe and involve mainly white persons.
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