Role of statin therapy in the management of patients with the metabolic syndrome
Year: 2007
Type: article
Abstract: Patients with the metabolic syndrome (MS) have an increased risk of developing cardiovascular disease (CVD) and diabetes. Treatment goals to reduce this risk include aggressive lipid lowering. However, despite aggressive management with statins, there remains a high residual risk in patients with MS. Clinical trials continue to provide evidence that more aggressive risk factor modification results in improved CVD outcomes, but implementation and achievement of the myriad of goals frequently requires multiple therapeutic approaches. The addition of combination therapy with statins is emerging as the optimal therapeutic approach to further lower the risk of CVD in patients with MS. The metabolic syndrome (MS) describes a clustering of modifiable risk factors associated with an increased risk of developing cardiovascular disease and diabetes [1-4]. These risk factors include various combinations of hypertension, abdominal obesity, glucose intolerance, and atherogenic dyslipidemia [4-7]. The prevalence of the MS represents a growing public health problem, following the global increasing trends in obesity, diabetes and aging of the population. Lifestyle change directed toward weight reduction and increased physical activity is essential and considered to be the first-line approach to reducing the risk factors associated with the MS. However, patients with the MS often require pharmacologic intervention for the management of dyslipidemia, hypertension, and hyperglycemia to further reduce their risk for coronary heart disease (CHD) [8]. The major abnormalities that constitute the atherogenic dyslipidemia associated with the MS include low levels of high-density lipoprotein (HDL) cholesterol, high levels of triglycerides (TG), as well as elevated numbers of small, dense, low-density lipoprotein (LDL) particles [9]. The LDL cholesterol levels may be increased however may also remain within the normal range. In fact, studies have shown that the risk of CHD in patients with MS is increased irrespective of absolute LDL levels [4]. It is the increased density and decreased size of the LDL particles in the MS that is believed to enhance their atherogenicity. It is well accepted that statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, lower LDL cholesterol levels and reduce the risk of cardiovascular events in many high-risk patients [7, 8, 10]. Statins have also been shown to increase HDL and lower TG levels. In addition,
Source: Archives of Medical Science
Authors: Ewa Dembowski, Michael H. Davidson
Institution: University of Chicago
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,078
OpenAlex ID: W2183227776