[HMG-CoA-reductase inhibitors: a new principle in the treatment of hypercholesterolemia].

HMG-CoA reductase inhibitors are a new class of drugs, which inhibit de novo cholesterol biosynthesis and significantly reduces the blood cholesterol concentrations. Three separate inhibitors, lovastatin, simvastatin and pravastatin can lower plasma total cholesterol and low-density lipoprotein (LDL) levels in hypercholesterolemic humans by 20 to 30% and 30 to 40%, respectively. The reduction in the levels of circulating atherogenic lipoprotein particles occurs as a result of decreased synthesis and enhanced removal of LDLs by the LDL receptor pathway in hepatocytes. Moreover, the levels of high-density lipoprotein (HDL-)cholesterol, which are inversely related to atherosclerosis, increase with treatment by these drugs. If the short-term safety of these drugs extends to ongoing longterm studies and if cardiovascular morbidity and mortality are improved by their use, these hypolipidemic agents will facilitate the effective treatment of hypercholesterolemia.