How safe is aggressive statin therapy?
The most recent guidelines of the National Cholesterol Education Program recommend more aggressive low-density lipoprotein cholesterol goals: <100 mg/dL for patients at moderate or high risk of cardiovascular disease, and <70 mg/dL for patients at very high risk. These lower goals are more likely to be achieved using the more powerful statins--atorvastatin, rosuvastatin, and simvastatin. Although statins are widely used, extensively studied, and known to have an excellent safety profile, the perception of many health care providers and patients is that safety concerns about the more efficacious statins, especially at high doses, limit their use. However, clinical data consistently support the view that adverse events are uncommon even when intensive therapy is used to reach aggressive low-density lipoprotein cholesterol goals. Overall, the more potent statins have similar safety profiles. The benefits of aggressive statin treatment in reducing the risk of cardiovascular events appear to far outweigh any potential risks of adverse events.
Guthrie
Robert M
RM
The Ohio State University College of Medicine, Columbus, OH 43212, USA. guthrie.1@osu.edu
D000069059:Atorvastatin; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D005464:Fluorobenzenes / Q000009:adverse effects / Q000494:pharmacology; D006538:Heptanoic Acids / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D006937:Hypercholesterolemia / Q000188:drug therapy*; D009135:Muscular Diseases / Q000139:chemically induced; D011743:Pyrimidines / Q000009:adverse effects / Q000494:pharmacology; D011758:Pyrroles / Q000009:adverse effects / Q000494:pharmacology; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000009:adverse effects / Q000494:pharmacology; D013449:Sulfonamides / Q000009:adverse effects / Q000494:pharmacology
D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D019821:Simvastatin