Efficacy, effectiveness and real life goal attainment of statins in managing cardiovascular risk

Review

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Authors: Naila Goldenberg, Charles Glueck

Published Date April 2009 Volume 2009:5 Pages 369 - 376

DOI: http://dx.doi.org/10.2147/VHRM.S3241

Naila Goldenberg^1,2, Charles Glueck¹

¹Cholesterol and Metabolism Center of Jewish Hospital, Cincinnati, Ohio, USA; ²University of Cincinnati, Division of Endocrinology and Metabolism, Cincinnati, Ohio, USA

Abstract: Statins became available for the treatment of hypercholesterolemia in 1987. Multiple, well-designed, placebo-controlled, double-blind studies revealed that each 1% reduction in serum cholesterol level was associated with about 1% reduction in risk of cardiovascular events. Low-density lipoprotein (LDL) cholesterol reduction to less than 78 mg/dL may be associated with reduction of atheroma burden. Patients with high levels of high specificity C-reactive protein and having LDL cholesterol less than 3.4 mmol/L (130 mg/dL) in primary prevention settings benefited from aggressive LDL cholesterol reduction with rosuvastatin over a 2-year period. However, in real life practice, about half of patients who are prescribed statins discontinue the medication by the end of the year. Medication adherence is lower in younger patients, women, and absence of known coronary heart disease. Personal features of the prescribing physician and dispensing pharmacies also affect patients’ compliance. More studies are needed to evaluate if “compliance packets” would benefit patients in a real life situation.

Keywords: cardiovascular risk, statin, goal attainment, primary prevention, secondary prevention