LDL cholesterol targets--how low to go?
PURPOSE OF REVIEW: Lowering LDL cholesterol (LDL-C) reduces vascular risk. Current guidelines recommend initiating statin therapy in patients with a yearly coronary heart disease risk of around 1.5-2%, and most clinicians prescribe standard statin regimens (e.g. 40 mg simvastatin daily). However, t...
| Main Authors: | , |
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| Format: | Journal article |
| Language: | English |
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2012
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| _version_ | 1826286777283903488 |
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| author | Bulbulia, R Armitage, J |
| author_facet | Bulbulia, R Armitage, J |
| author_sort | Bulbulia, R |
| collection | OXFORD |
| description | PURPOSE OF REVIEW: Lowering LDL cholesterol (LDL-C) reduces vascular risk. Current guidelines recommend initiating statin therapy in patients with a yearly coronary heart disease risk of around 1.5-2%, and most clinicians prescribe standard statin regimens (e.g. 40 mg simvastatin daily). However, there is some uncertainty about whether patients at somewhat lower vascular risk should receive lipid-lowering therapy and also how intensive statin treatment should be. RECENT FINDINGS: Lowering LDL-C by around 1 mmol/l reduces vascular mortality and major morbidity by about one-fifth, and more recent randomized trials comparing intensive versus standard statin regimens confirm that a further LDL-C reduction of 0.5 mmol/l results in an additional 15% reduction in the risk of a major vascular event. Furthermore, statin therapy significantly reduces vascular mortality and morbidity in patients with less than 1% annual risk of a major vascular event. In general, statins are safe and well tolerated, but 80 mg simvastatin is associated with an unacceptably high risk of statin-induced myopathy. SUMMARY: Lipid-lowering therapy with statins is cost-effective for a wider range of patients than currently recommended. Intensive statin therapy is associated with larger reductions in vascular risk, and lower LDL-C targets (particularly for higher-risk individuals) should help reduce vascular mortality and major vascular morbidity substantially. |
| first_indexed | 2024-03-07T01:48:46Z |
| format | Journal article |
| id | oxford-uuid:995605a2-62b8-4a54-a2a3-1d5cba6152ff |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:48:46Z |
| publishDate | 2012 |
| record_format | dspace |
| spelling | oxford-uuid:995605a2-62b8-4a54-a2a3-1d5cba6152ff2022-03-27T00:13:37ZLDL cholesterol targets--how low to go?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:995605a2-62b8-4a54-a2a3-1d5cba6152ffEnglishSymplectic Elements at Oxford2012Bulbulia, RArmitage, J PURPOSE OF REVIEW: Lowering LDL cholesterol (LDL-C) reduces vascular risk. Current guidelines recommend initiating statin therapy in patients with a yearly coronary heart disease risk of around 1.5-2%, and most clinicians prescribe standard statin regimens (e.g. 40 mg simvastatin daily). However, there is some uncertainty about whether patients at somewhat lower vascular risk should receive lipid-lowering therapy and also how intensive statin treatment should be. RECENT FINDINGS: Lowering LDL-C by around 1 mmol/l reduces vascular mortality and major morbidity by about one-fifth, and more recent randomized trials comparing intensive versus standard statin regimens confirm that a further LDL-C reduction of 0.5 mmol/l results in an additional 15% reduction in the risk of a major vascular event. Furthermore, statin therapy significantly reduces vascular mortality and morbidity in patients with less than 1% annual risk of a major vascular event. In general, statins are safe and well tolerated, but 80 mg simvastatin is associated with an unacceptably high risk of statin-induced myopathy. SUMMARY: Lipid-lowering therapy with statins is cost-effective for a wider range of patients than currently recommended. Intensive statin therapy is associated with larger reductions in vascular risk, and lower LDL-C targets (particularly for higher-risk individuals) should help reduce vascular mortality and major vascular morbidity substantially. |
| spellingShingle | Bulbulia, R Armitage, J LDL cholesterol targets--how low to go? |
| title | LDL cholesterol targets--how low to go? |
| title_full | LDL cholesterol targets--how low to go? |
| title_fullStr | LDL cholesterol targets--how low to go? |
| title_full_unstemmed | LDL cholesterol targets--how low to go? |
| title_short | LDL cholesterol targets--how low to go? |
| title_sort | ldl cholesterol targets how low to go |
| work_keys_str_mv | AT bulbuliar ldlcholesteroltargetshowlowtogo AT armitagej ldlcholesteroltargetshowlowtogo |