The role of statins in vascular disease.
BACKGROUND
Recent publications have highlighted the benefits of statins in non-cardiac occlusive disease but also the failure of vascular surgeons to recognise and treat the risk factors for atherosclerosis, in particular hypercholesterolaemia. The aim of this review is to clarify the current experimental and clinical evidence for the use of statins in vascular disease.


METHODS
Literature compiled from an extensive search of Medline and the Cochrane database has been used for the basis of this review.


RESULTS
Experimental and clinical evidence consistently reports that statins improve endothelial dysfunction, are anti-inflammatory, anti-proliferative, anti-thrombogenic and anti-proteolytic. These effects are known to inhibit atherogenesis and improve plaque stability. Independent groups support the use of statins in the prevention of both primary and secondary cardiac events. The National Stroke association recommends their use to reduce strokes following myocardial infarction and the Heart Protection Study reports benefits in patients with non-cardiac occlusive disease.


CONCLUSIONS
There is substantial evidence advocating the use of statins in patients with clinically significant vascular disease. In the future this may evolve to include those patients at risk from neointimal hyperplasia, aneurysmal disease and ischaemia reperfusion injury.
Laws
P E
PE
Department of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Woodville, SA, Australia.
Spark
J I
JI
Cowled
P A
PA
Fitridge
R A
RA
D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000503:physiopathology; D008078:Cholesterol, LDL / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D014652:Vascular Diseases / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors