[Hypolipemic treatment in the prevention of atherosclerotic plaque complications].
OBJECTIVE
Hypercholesterolemia has been shown to be a definite risk factor for coronary disease, although its relevance in cerebrovascular disease is more controversial. This study reviews the part played by different hypolipemic treatments in primary and secondary prevention of the complications of atherothrombotic diseases, particularly stroke.


METHODS
We based our study mainly on the HMG-CoA inhibitors (3-hydroxyl 3 methyl glutaryl coenzyme A) reductase, or statins++. This group of drugs acts by inhibiting the synthesis of cholesterol and increasing the expression of LDL-c receptors, achieving a 25-35% lowering of plasma LDL-c levels. In diverse clinical trials they have been shown to have a beneficial effect in the prevention of cardiovascular disease. The results of these studies indicate that, in addition to their purely hypolipemic effect, other anti-atherothrombotic mechanisms are involved. We analyze the main studies on hypolipemic drugs in the primary and secondary prevention of coronary and cardiovascular disease.


CONCLUSIONS
The role of statins is clearly defined in reduction of the risk of overall and cardiovascular mortality, and also in reduction of the incidence of cardiovascular incidents in patients with a past history of coronary disease and a cholesterol level over 155 mg/dl. Reduction of the risk from cerebrovascular disease has only been observed in primary prevention studies (patients with a past history of coronary disease). Therefore, we shall have to await the results of the clinical trials currently being carried out to determine the true role of statins in the secondary prevention of cerebrovascular disease.
Vivancos-Mora
J
J
Servicio de Neurología, Hospital Universitario de la Princesa, Madrid, España.
León-Colombo
T
T
Monforte-Dupret
C
C
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D020521:Stroke / Q000209:etiology / Q000517:prevention & control
D000924:Anticholesteremic Agents