New evidence supporting aggressive lipid lowering.
Epidemiologic and clinical studies clearly establish the relationship between low-density lipoprotein cholesterol (LDL-C) levels and coronary heart disease (CHD). As such, the National Cholesterol Education Program (NCEP) has advocated an LDL-C goal of less than 100 mg/dL in patients with established CHD and in those who are CHD risk-equivalent. Whether aggressive reductions beyond this target will provide additional decreases in CHD mortality has yet to be determined. Recent studies show that aggressive LDL-C reduction was associated with less atherosclerosis progression, lower rates of revascularization, and fewer ischemic events compared with moderate LDL-C reduction or conventional treatment. The statins are the most effective medications available for reducing LDL-C levels. Atorvastatin is the most effective of the currently available statins, but rosuvastatin, an agent in development, appears to be even more effective and allows patients with mild-to-moderate hypercholesterolemia or heterozygous familial hypercholesterolemia to achieve the recommended LDL-C targets. Statins, alone or in combination with other such medications, provide physicians with the tools to ensure that the vast majority of patients can be treated according to the current NCEP guidelines.
Stein
Evan A
EA
Metabolic and Atherosclerosis Research Center, University of Cincinnati Medical Center, Cincinnati, OH 45219, USA.
D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors