PRIMARY PREVENTION OF CARDIOVASCULAR-DISEASE - IMPLICATIONS OF LIPID-LOWERING TRIALS

Available lipid-lowering treatment Aggressive cholesterol-lowering wit h 3-hydroxy-3-methylglutaryl (HMG)-coenzyme A reductase inhibitors has proved to be more effective than drugs available in the past This tre atment is safe and reduces morbidity and mortality from coronary heart disease substantially in all categories of patients at risk. The effe ct of treatment on clinical events is proportional to the reduction in low-density-lipoprotein cholesterol. Future prospects In the future, even more effective drugs will become available that may yield even gr eater benefit than has been observed in trials until now. At present, this therapy is too expensive for use in a mass strategy to prevent co ronary heart disease. Therefore, it should be limited to patients with a high risk. When further development brings newer drugs with a lower cost drug treatment for cholesterol-lowering may become as widespread as antihypertensive treatment is today in order to prevent cardiovasc ular disease.