Effects of statins on the vasculature: Implications for aggressive lipid management in the cardiovascular metabolic syndrome.
The cardiovascular metabolic syndrome is a family of risk factors that predispose patients to develop diabetes and cardiovascular disease. Indeed, macrovascular, not microvascular, disease is the leading cause of death in these patients. The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) exert both direct and indirect (cholesterol-lowering) effects on the vasculature. Clinical trials have shown that these agents reduce cardiovascular disease and cerebrovascular disease in persons with diabetes. However, their beneficial effects on diabetic dyslipidemia do not account for all of the observed risk reduction. Positive effects on nitric oxide metabolism, inflammation, coagulability, and adhesion of cells to the vascular endothelium likely contribute to the mechanism of action of these agents. These pleiotropic effects of statins on the vasculature will be discussed in this review.
Sowers
James R
JR
Endocrine Division, State University of New York Downstate, Brooklyn 11203, USA. jsowers@netmail.hscbklyn.edu
D000924:Anticholesteremic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004730:Endothelium, Vascular / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D024821:Metabolic Syndrome / Q000188:drug therapy*
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors