Medicus, Vol. 12 No. 1_ Kardiologija, 2003.
Review article
Statins in Primary and Secondary Prevention of Coronary Heart Disease
Željko Reiner
Abstract
Although treatment with HMG-CoA reductase
inhibitors (statins) to reduce total and LDL-cholesterol is
clearly indicated in patients with coronary heart disease (CHD)
and those with increased risk due to hyperlipidemia, the
requirements of patients with lower risk were until recently
less straightforward. The results of recent large clinical trials
with statins and almost two decades of clinical experience
have shown that statins are effective and well tolerated in
reducing CHD risk for both primary and secondary prevention.
The beneficial effects of statins outweigh those seen in earlier
trials with other hypolipemic drugs and occur too early in
treatment to be due to lipid lowering mechanism alone. Therefore
this happens presumably not only because of the greater
reduction in lipids but because of their so-called “pleiotropic”
antiatherogenic effects. Recent clinical trials have proved that
lipid lowering therapy with statins is no longer just a matter of
hyperlipidemia treatment but rather a way of lowering risk of
CHD morbidity and mortality in a large number of individuals
at high risk. However, the data from several studies have
shown that many CHD patients (and even more individuals at
high risk) either receive no treatment at all, or are not treated
to recommended lipid goals. Since undertreatment is a big
problem, particularly in Croatia, this issue should be strongly
addressed.
Keywords
statins; hypercholesterolemia; coronary heart disease; acute myocardial infarction
Hrčak ID:
20523
URI
Publication date:
27.1.2003.
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