Cholesterol-Lowering Drugs: Can They Do More?

By Christine Haran

Over the last 20 years, statins, which include drugs such as Zocor, Pravachol and Lipitor, have had a remarkable impact on heart disease. These drugs rid the bloodstream of cholesterol, a fatty substance produced primarily by the liver and acquired from dietary sources. Statins are particularly good at removing low-density lipoprotein (LDL) cholesterol, considered the "bad" cholesterol, which can build up in the blood vessels to cause blockages in arteries that supply the heart and brain thus preventing heart disease and stroke.

But lately it seems like every week there's a new study released that points to another condition the cholesterol-busting drugs might help treat and even prevent. And there have been murmurs that these drugs may one day be the new aspirin, which is also used for many different purposes. Although much more research is needed, there is some preliminary evidence that suggests that statins may benefit people with conditions other than high cholesterol, such as those with high blood pressure, Alzheimer's disease, osteoporosis and multiple sclerosis. Below, cardiologist and researcher Dr. Antonio Gotto, dean of Weill Cornell Medical College in New York City, discusses the potential of statins.

How are statins currently used?
Statins are currently recommended, primarily, to reduce total cholesterol and LDL (low-density lipoprotein) cholesterol, which is considered the bad cholesterol. In patients with established cardiovascular disease, statins are used to lower cholesterol to meet the National Cholesterol Education Program (NCEP) target values. (The NCEP was launched by the National Heart, Lung, and Blood Institute to lower rates of coronary heart disease.) According to the NCEP guidelines, someone who has a history of coronary disease or who has a high level of risk for developing heart disease in the next 10 years, for example, should have a target LDL cholesterol value of less than 100 mg/dL. Lowering cholesterol to these target values has been associated with a reduction in major cardiovascular events, stroke and the need for revascularization procedures, such as balloon angioplasty, to restore blood flow to blocked arteries. For patients with high cholesterol who do not have heart disease, statins are recommended for the reduction of the risk of cardiovascular events, such as heart attack.

Statins can also slow the progression of atherosclerotic disease, or the build-up of plaque consisting of LDL cholesterol and other substances, in the coronary and carotid arteries. These arteries are the major arteries that supply blood to the heart and the brain, respectively.

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