Cholesterol-Lowering Drugs and Therapies in Cardiovascular Disease

Abstract

Dyslipidemia is a major risk factor for cardiovascular disease (CVD). The relationship between low-density lipoprotein concentration and cardiovascular (CV) risk has been well established in numerous epidemiological studies. The benefit of cholesterol- lowering agents has been demonstrated in patients with known CVD. On the other hand, in patients without known CVD the decision to start therapy depends on their 10-year risk prediction of CV events. 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG- CoA) reductase inhibitors (“statins”), a mainstay of cholesterol-lowering therapy, have been shown to reduce both CV events and all-cause mortality. Other lipid-lowering measures (both pharmacological and nonpharmacological) have also been demonstrat- ed in clinical trials to reduce CV outcomes. In this chapter, we review contemporary therapies used to treat dyslipidemia and discuss future directions including novel agents on the horizon.