[Antilipemics: from prevention to protection]

Statins and fibrates have been demonstrated to prevent both cardiovascular events and stroke. While this preventive effect was initially thought to be related to their lipid-lowering effects, in particular hypocholesterolaemic effect, analysis of primary and secondary prevention trials suggest that these preventive effects could be partly independent of their effects on lipid disorders. The pleiotropic effects, such as vascular, anti-inflammatory or anti-oxidants effects, were described for both the statins and fibrates. In addition to the preventive effects, these pleiotropic effects could partially explain the decrease in myocardial or cerebral ischemia consequences in experimental models. These cellular protective effects may have a therapeutic interest to decrease severity of stroke or coronary acute syndrome. They could also explain the drugs' lipid-lowering preventive effects independent of the treatment of lipid disorders. Beyond vascular pathologies, the pleiotropic effects of lipid-lowering drugs could explain their potentially beneficial effect in different diseases, such as dementia or cancer.