Undertreatment or Overtreatment With Statins: Where Are We?
Statins, in addition to healthy lifestyle interventions, are the cornerstone of lipid-lowering therapy. Other low-density lipoprotein (LDL)-lowering drugs include ezetimibe, bile acid sequestrants, and PCSK9 inhibitors. As new evidence emerges from new clinical trials, therapeutic goals change, lead...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.808712/full |
| _version_ | 1818009406986518528 |
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| author | Irene García-Fernández-Bravo Ana Torres-Do-Rego Ana Torres-Do-Rego Ana Torres-Do-Rego Antonio López-Farré Francisco Galeano-Valle Francisco Galeano-Valle Francisco Galeano-Valle Pablo Demelo-Rodriguez Pablo Demelo-Rodriguez Pablo Demelo-Rodriguez Luis A. Alvarez-Sala-Walther Luis A. Alvarez-Sala-Walther Luis A. Alvarez-Sala-Walther |
| author_facet | Irene García-Fernández-Bravo Ana Torres-Do-Rego Ana Torres-Do-Rego Ana Torres-Do-Rego Antonio López-Farré Francisco Galeano-Valle Francisco Galeano-Valle Francisco Galeano-Valle Pablo Demelo-Rodriguez Pablo Demelo-Rodriguez Pablo Demelo-Rodriguez Luis A. Alvarez-Sala-Walther Luis A. Alvarez-Sala-Walther Luis A. Alvarez-Sala-Walther |
| author_sort | Irene García-Fernández-Bravo |
| collection | DOAJ |
| description | Statins, in addition to healthy lifestyle interventions, are the cornerstone of lipid-lowering therapy. Other low-density lipoprotein (LDL)-lowering drugs include ezetimibe, bile acid sequestrants, and PCSK9 inhibitors. As new evidence emerges from new clinical trials, therapeutic goals change, leading to renewed clinical guidelines. Nowadays, LDL goals are getting lower, leading to the “lower is better” paradigm in LDL-cholesterol (LDL-C) management. Several observational studies have shown that LDL-C control in real life is suboptimal in both primary and secondary preventions. It is critical to enhance the adherence to guideline recommendations through shared decision-making between clinicians and patients, with patient engagement in selecting interventions based on individual values, preferences, and associated conditions and comorbidities. This narrative review summarizes the evidence regarding the benefits of lipid-lowering drugs in reducing cardiovascular events, the pleiotropic effect of statins, real-world data on overtreatment and undertreatment of lipid-lowering therapies, and the changing LDL-C in targets in the clinical guidelines of dyslipidemias over the years. |
| first_indexed | 2024-04-14T05:42:28Z |
| format | Article |
| id | doaj.art-c759242c5542401b8fe298fde48a7027 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-14T05:42:28Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-c759242c5542401b8fe298fde48a70272022-12-22T02:09:24ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-04-01910.3389/fcvm.2022.808712808712Undertreatment or Overtreatment With Statins: Where Are We?Irene García-Fernández-Bravo0Ana Torres-Do-Rego1Ana Torres-Do-Rego2Ana Torres-Do-Rego3Antonio López-Farré4Francisco Galeano-Valle5Francisco Galeano-Valle6Francisco Galeano-Valle7Pablo Demelo-Rodriguez8Pablo Demelo-Rodriguez9Pablo Demelo-Rodriguez10Luis A. Alvarez-Sala-Walther11Luis A. Alvarez-Sala-Walther12Luis A. Alvarez-Sala-Walther13Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, SpainInternal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, SpainGrupo (departamento) de investigación Riesgo cardiovascular y lípidos, Instituto de investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, SpainDepartment of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainDepartment of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainInternal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, SpainGrupo (departamento) de investigación Riesgo cardiovascular y lípidos, Instituto de investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, SpainDepartment of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainInternal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, SpainGrupo (departamento) de investigación Riesgo cardiovascular y lípidos, Instituto de investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, SpainDepartment of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainInternal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, SpainGrupo (departamento) de investigación Riesgo cardiovascular y lípidos, Instituto de investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, SpainDepartment of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, SpainStatins, in addition to healthy lifestyle interventions, are the cornerstone of lipid-lowering therapy. Other low-density lipoprotein (LDL)-lowering drugs include ezetimibe, bile acid sequestrants, and PCSK9 inhibitors. As new evidence emerges from new clinical trials, therapeutic goals change, leading to renewed clinical guidelines. Nowadays, LDL goals are getting lower, leading to the “lower is better” paradigm in LDL-cholesterol (LDL-C) management. Several observational studies have shown that LDL-C control in real life is suboptimal in both primary and secondary preventions. It is critical to enhance the adherence to guideline recommendations through shared decision-making between clinicians and patients, with patient engagement in selecting interventions based on individual values, preferences, and associated conditions and comorbidities. This narrative review summarizes the evidence regarding the benefits of lipid-lowering drugs in reducing cardiovascular events, the pleiotropic effect of statins, real-world data on overtreatment and undertreatment of lipid-lowering therapies, and the changing LDL-C in targets in the clinical guidelines of dyslipidemias over the years.https://www.frontiersin.org/articles/10.3389/fcvm.2022.808712/fullstatinscardiovascular riskHDL-cholesterolLDL-cholesterolPCSK9 inhibitorprimary prevention |
| spellingShingle | Irene García-Fernández-Bravo Ana Torres-Do-Rego Ana Torres-Do-Rego Ana Torres-Do-Rego Antonio López-Farré Francisco Galeano-Valle Francisco Galeano-Valle Francisco Galeano-Valle Pablo Demelo-Rodriguez Pablo Demelo-Rodriguez Pablo Demelo-Rodriguez Luis A. Alvarez-Sala-Walther Luis A. Alvarez-Sala-Walther Luis A. Alvarez-Sala-Walther Undertreatment or Overtreatment With Statins: Where Are We? Frontiers in Cardiovascular Medicine statins cardiovascular risk HDL-cholesterol LDL-cholesterol PCSK9 inhibitor primary prevention |
| title | Undertreatment or Overtreatment With Statins: Where Are We? |
| title_full | Undertreatment or Overtreatment With Statins: Where Are We? |
| title_fullStr | Undertreatment or Overtreatment With Statins: Where Are We? |
| title_full_unstemmed | Undertreatment or Overtreatment With Statins: Where Are We? |
| title_short | Undertreatment or Overtreatment With Statins: Where Are We? |
| title_sort | undertreatment or overtreatment with statins where are we |
| topic | statins cardiovascular risk HDL-cholesterol LDL-cholesterol PCSK9 inhibitor primary prevention |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.808712/full |
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