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The future direction of cholesterol-lowering therapy
Marc Evans1, Aled Roberts, Alan Rees
1Department of Metabolic Medicine, University Hospital of Wales, Cardiff, UK. marc.evans2@ntlworld.com
Current Opinion in Lipidology
|November 21, 2002
Summary
Aggressive cholesterol reduction benefits cardiovascular health, with no lower threshold for low-density lipoprotein (LDL) cholesterol. New therapies like rosuvastatin and ezetimibe help achieve lower LDL levels for high-risk patients.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Observational studies indicate a continuous link between vascular risk and cholesterol levels.
- Current guidelines may lead to undertreatment of high-risk individuals due to cholesterol targets.
Purpose of the Study:
- To review clinical trials on optimal cholesterol reduction goals.
- To discuss new lipid-lowering therapies and their relation to existing guidelines.
Main Methods:
- Review of observational studies and clinical trials.
- Discussion of novel lipid-lowering agents: rosuvastatin and ezetimibe.
Main Results:
- The Heart Protection Study showed LDL cholesterol reduction to 1.7 mmol/l provided significant clinical benefit.
- No apparent threshold for LDL cholesterol was identified regarding cardiovascular risk.
- New therapies like rosuvastatin (statin) and ezetimibe (cholesterol absorption inhibitor) offer potent LDL reduction.
Conclusions:
- Evidence supports the safety and benefits of aggressive cholesterol reduction.
- Newer therapies and combination treatments can achieve lower cholesterol levels.
- Further outcome studies are needed to confirm optimal LDL cholesterol targets.