Statins : focus on their role in the prevention of cardiovascular disease

Statins are the most effective drugs for lowering LDL- cholesterol ( the "bad" cholesterol ), but only when the treatment is accompanied by a low -fat diet , said Dr Philippe Giral , the unit cardiovascular disease prevention Pitié- Salpêtrière ( AP- HP , Paris XIII ) .
Statins : to treat and prevent ...
It is during the traditional presentation of the annual report prepared by therapeutic advances Leem ( Pharmaceutical companies ) that the doctor gave an update on the role of statins in cardiovascular prevention.

Indeed , the assessment of drug manufacturers is a great way to progress in terms of preventive cardiology. And among the half- dozen records progress in this field in 2003, two concern the statin family . Thus, besides the appearance of a new representative of this group, already marketed statins received a new indication .

Statins , the beneficial effects of accidents and cardiovascular mortality were identified in the mid- 1990s, were prescribed to approximately 400,000 patients in Ile -de- France , said Dr. Philippe Giral .

Lipid-lowering treatment of choice
These molecules have a chemical structure that resembles a precursor of cholesterol, which allows them to take his place. And so they inhibit the synthesis of cholesterol from the start of its " production line " , which takes place in hepatocytes ( liver cells ) .

However , cholesterol is necessary : it participates in the formation of cell membranes, in the synthesis of certain hormones and bile constituents . When the body does not synthesize enough to meet its needs, in particular in the stock fee of LDL ("bad " cholesterol deposits on the artery walls , reducing their diameter and upset the flow passage blood ) , which explains how statins reduce LDL - cholesterol.

" In all, a dozen clinical studies have examined the effect of statins on blood lipid levels , based on the observation of nearly 65,000 patients. Their findings helped highlight that these molecules allow reduce both LDL - cholesterol and the triglycerides, while increasing HDL cholesterol ( the "good" cholesterol " , which is taken at the arterial wall to be reused in the liver ) " said Dr Philippe Giral .

Two advantages: effective and well tolerated
" A number of parameters influence the effectiveness of this treatment as prescribed molecule, the initial level of lipid levels or genetic factors . But the lifestyle is obviously a key element to its success and a balanced diet always necessary, " he added .

Other studies have confirmed the efficacy of statins in both primary prevention (to avoid the occurrence of a first cardiovascular event ) and in secondary prevention (to prevent recurrence ) . Thus , in addition to circulating lipid levels , these drugs reduce the number of heart attacks, and the number of deaths from myocardial infarction and / or coronary artery disease.

" Statins are therefore the most commonly used units in prevention of cardiovascular disease treatments," said Dr. Philippe Giral . " And if one of the products of this family had to be withdrawn from the market in 2001 because he had severe muscle toxicity, shows negligible risk for the other statins ," he said .

What future for statins ?
But questions still remain unanswered , especially with regard to the comparison of the effectiveness of statins in relation to each other .

" With regard to their effect on cholesterol levels , doctors still wonder : how far should we bring down this parameter Should we consider that it should respond to the expression 'the lower , ? the better '(the minimum the better) ? "said Dr. Philippe Giral .

Studies are underway to determine whether statins could have an effect in preventing Alzheimer's disease and osteoporosis (comparing their influence to that of a placebo , an inactive substance). But the first results rather disappointing , are highly controversial .