A triumvirate of targets in the prevention and treatment paradigm for cardiovascular disease.

Statins have revolutionized the management of cardiovascular disease (CVD). Reductions in low-density lipoprotein cholesterol (LDL-C) with statin therapy have been shown to reduce significantly the risk of CVD in primary and secondary prevention trials. Recent evidence from clinical trials supports the concept that lower LDL-C levels, below current guideline targets, provide additional protection against cardiovascular (CV) events. In addition evidence is accumulating that increasing high-density lipoprotein cholesterol (HDL-C) and decreasing the level of chronic inflammation are important targets in CVD risk reduction. Recent studies have investigated the effectiveness of statins in terms of their ability to concomitantly reduce LDL-C, increase HDL-C and lower C-reactive protein (CRP). Results demonstrate that the more effective statins have beneficial effects on this triumvirate of potential treatment targets. Furthermore, the overall safety and tolerability profile is comparable among available statins. This paper examines recent data highlighting the role that statins and other lipid-lowering agents can play in this new treatment paradigm.