Current perspectives on statins

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 triglycer ide levels in hypertriglyceridemic patients. Statins are well tolerated and have an excellent safety record. Clinical trials in patients with and with out coronary heart disease and with and without high cholesterol have demon strated consistently that statins reduce the-relative risk of major coronar y events by approximate to 30% and produce a greater absolute benefit in pa tients with higher baseline risk. Proposed mechanisms include favorable eff ects on plasma lipoproteins, endothelial function, plaque architecture and stability, thrombosis, and inflammation. Mechanisms independent of LDL lowe ring may play an important role in the clinical benefits conferred by these drugs and may ultimately broaden their indication from lipid-lowering to a ntiatherogenic agents.