Aggressive lipid therapy in the statin era

Aggressive cholesterol lowering with 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitor (statin) therapy has contributed to the substantial decrease in coronary heart disease (CHD) morbidity and mortality in recent years, as documented in a number of controlled clinical trials in both primary- and secondary-prevention patients. Although benefit was first established in patients with severe hypercholesterolemia, more recent trials have extended the benefit to patients with mildly to moderately elevated cholesterol. In addition to improvements on the lipid profile, statins appear to confer nonlipid benefits, such as improved endothelial function, modification of plaque cellularity, and plaque stabilization.