Reversible and non-reversible cardiovascular risk in patients treated with lipid-lowering therapy: analysis of SEAS and JUPITER trials.
A number of clinical trials have confirmed that statin treatment and, more generally, LDL-lowering treatment, are able to reduce CHD and CVD events in a wide range of clinical conditions associated with increased cardiovascular risk. However, the most recent trials have also identified patient groups in which lipid-lowering treatment shows a more limited preventive potential due to the "non-reversibility" of part of the cardiovascular risk, which dilutes the observed treatment effect by events that are not directly a consequence of atherosclerosis. The use of lipid-lowering therapy in these patients should be driven not only by their absolute risk, as suggested by the most recent American and European guidelines, but also by their overall clinical setting and by the evidence of benefit obtained in controlled trials in comparable populations.
Poli
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Department of Pharmacological Sciences, University of Milan, Italy. poli@nutrition-foundation.it
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D000924:Anticholesteremic Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D001384:Azetidines / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D000069438:Ezetimibe; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000453:epidemiology*; D012307:Risk Factors
D000924:Anticholesteremic Agents; D001384:Azetidines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069438:Ezetimibe