EFFECTS OF LIPID-LOWERING TREATMENT ON CO RONARY PERFUSION

Secondary intervention trials in coronary heart disease have unequivoc ally proven the effectiveness of Lipid-lowering medication in addition to dietary means. Orderly application of available drugs leads to red uctions in LDL cholesterol and triglycerides accompanied by increases in HDL cholesterol. Specifically, LDL cholesterol lowering is associat ed with clinical benefits in coronary heart disease, it reduces the ne cessity of hospitalization and interventions, and leads to significant reductions in coronary as well as in overall mortality. Besides morph ological changes of coronary vessels like regression or retarded progr ession of plaques, lipid-lowering was shown to normalize endothelial d ysfunction associated with hyperlipidemia. Restoring endothelial funct ion and improving coronary perfusion may be one of the factors respons ible for the huge clinical benefits in secondary intervention trials a s compared to the modest morphological changes. As the fact of lipid-l owering rather than the means by which it is achieved is of specific i mportance, dietary means have to precede and then accompany an eventua l additional drug treatment.