(Circulation. 2000;101:207.)
© 2000 American Heart Association, Inc.
Cardiovascular Drugs |
Current Perspectives on Statins
From the Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University, School of Medicine, Nashville, Tenn.
Abstract—Statins (HMG-CoA
reductase inhibitors) are used widely for the treatment of
hypercholesterolemia. They inhibit HMG-CoA
reductase competitively, reduce LDL levels more than other
cholesterol-lowering drugs, and lower
triglyceride levels in
hypertriglyceridemic patients. Statins are
well tolerated and have an excellent safety record. Clinical trials
in patients with and without coronary heart disease and
with and without high cholesterol have demonstrated
consistently that statins reduce the relative risk of major
coronary events by 
30% and produce a greater absolute
benefit in patients with higher baseline risk. Proposed mechanisms
include favorable effects on plasma lipoproteins,
endothelial function, plaque architecture and
stability, thrombosis, and inflammation. Mechanisms independent of LDL
lowering may play an important role in the clinical benefits conferred
by these drugs and may ultimately broaden their indication from
lipid-lowering to antiatherogenic agents.
Key Words: statins • hypercholesterolemia • trials • atherosclerosis • coronary disease
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