Pravastatin: an evidence-based statin?
BACKGROUND
It is well known that statins lead to a markable reduction in cardiovascular morbidity and mortality. One of the first and best studied statins is pravastatin, which has been studied in both primary and secondary prevention trials. With 40 mg pravastatin daily, total cholesterol can be reduced by 25-34% with a very consistent risk reduction of 24% of death from cardiovascular diseases. Side effects are rare and usually consist of myopathy. Following the Adult Treatment Panel III (ATPIII) guidelines on cholesterol management, apart from therapeutic lifestyle changes, in high-risk patients (including patients with diabetes mellitus), cholesterol-lowering therapy should be targeted at a treatment goal of LDL cholesterol<2.5 mmol/l. Statin-lowering therapy should be commenced to adequately lower cardiovascular risk. Therefore, when the expected 25-34% LDL cholesterol lowering would be enough to reach an LDL<2.5 mmol/l, treatment should be started with pravastatin.


METHODS
Trials have shown that treatment with pravastatin is safe in older patients as well as in children with familial hypercholesterolemia.


CONCLUSIONS
Since obesity seems to become a worldwide problem and given the low costs of generic pravastatin, it may even be cost-effectively used in developing countries.
del Sol
Antonio Iglesias
AI
VU University Medical Center, Department of Internal Medicine, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Nanayakkara
Prabath W B
PW
D050197:Atherosclerosis / Q000150:complications / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D017035:Pravastatin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017035:Pravastatin