Achieving LDL-C target levels: the role of statins.
Epidemiological and clinical studies have clearly established the link between elevated low-density lipoprotein cholesterol (LDL-C) and coronary heart disease (CHD). Consequently, treatment guidelines have been developed that identify LDL-C as a causative factor for CHD and as a target for lipid-lowering therapy. The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are considered the drugs of choice for lowering LDL-C in patients with hypercholesterolaemia. However, despite the proven efficacy of statins in reducing LDL-C, many patients do not achieve recommended LDL-C target levels. Surveys suggest that patients do not receive the appropriate drugs in adequate dosage to reach LDL-C target values. Success in achieving targets is lowest in patients at the highest risk, i.e. those with established CHD. The introduction of more potent HMG-CoA reductase inhibitors, or the use of higher doses of older statins, should allow more patients to achieve LDL-C target levels.
Service de Cardiologie B et Hemodynamique, Hôpital Cardiologique, 59037 Lille, France. jmlablanche@chru-lille.fr
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Lablanche
D000924:Anticholesteremic Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000097:blood* / Q000187:drug effects*; D003327:Coronary Disease / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000150:complications* / Q000188:drug therapy*; D018579:Patient Selection; D012307:Risk Factors; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors