Addressing the challenge

Patients with hypercholesterolaemia are at an increased risk of coronary heart disease. Lowering elevated cholesterol levels has been shown to reduce effectively the risk of coronary events. Atorvastatin, a recently introduced statin, produces pronounced lipid-lowering via inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. For example, atorvastatin 10-80 mg.day-1 reduces low density lipoprotein cholesterol (LDL-C) from baseline by 41-61% in a dose-dependent manner. Atorvastatin also lowers triglyceride levels by 23-45% over the same dose range. While sharing a common mechanism of action with other statins, atorvastatin leads to greater decreases in LDL-C, total cholesterol, apolipoprotein B and triglyceride levels than other statins. In the CURVES study, atorvastatin 10-40 mg.day-1 produced greater reductions in LDL-C than milligram equivalent doses of comparator statins. Studies have also shown that relatively more patients treated with atorvastatin achieve LDL-C treatment goals, and at a lower overall cost, than those treated with other statins. A further advantage of this enhanced efficacy is that atorvastatin shares a safety profile similar to that of the other statins. The efficacy and safety of atorvastatin has been demonstrated in a range of patient subgroups. A comprehensive ongoing clinical programme for atorvastatin includes morbidity and mortality studies.