Mays Maureen E, Dujovne Carlos A
Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code UNH-62, Portland, OR 97239, USA.
Curr Atheroscler Rep. 2008 Feb;10(1):45-52. doi: 10.1007/s11883-008-0008-0.
Cardiovascular disease (CVD) is the leading cause of death in the developed world. Lower risks of morbidity and mortality in trials of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) have changed the conventional wisdom regarding lipid lowering. Since 2001, there have been surprising results concerning the early benefits of statin therapy, which suggest that some benefits may be derived from effects other than those of simply improving dyslipidemias. The earlier than expected CVD benefits from statin trials have led to the theory that statins have effects other than, or concomitant to, the benefits on serum lipid levels, and that these effects may be at least partly responsible for their early and often significant reduction in CVD risk. These have been defined as pleiotropic effects. Possible means by which statins reduce CVD risk independent of their lipid regulation may include antithrombotic and anti-inflammatory effects, antioxidation, plaque stabilization, and endothelial wall relaxation resulting in lower intra-arterial pressure and increased blood flow.
心血管疾病（CVD）是发达国家的主要死因。3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂（他汀类药物）试验中较低的发病率和死亡率风险改变了关于降脂的传统观念。自2001年以来，关于他汀类药物治疗的早期益处出现了令人惊讶的结果，这表明一些益处可能来自于单纯改善血脂异常以外的其他作用。他汀类药物试验中比预期更早出现的心血管疾病益处引发了这样一种理论，即他汀类药物除了对血脂水平有益外，还有其他作用，或者与这些益处同时存在，并且这些作用可能至少部分地解释了它们早期且常常显著降低心血管疾病风险的原因。这些作用被定义为多效性作用。他汀类药物独立于其血脂调节作用降低心血管疾病风险的可能途径包括抗血栓形成和抗炎作用、抗氧化作用、斑块稳定作用以及内皮壁舒张作用，从而降低动脉内压力并增加血流量。
