HMG-CoA reductase inhibitors: a look back and a look ahead.

Abstract

A look back indicates that HMG-CoA reductase inhibitors, as a class, appear to be safe and effective for long term use and constitute a major drug addition for the control of hypercholesterolemia. Combination therapy may enhance effectiveness but close monitoring is needed when used in conjunction with fibrates and nicotinic acid because of potential muscle toxicity. A look ahead uncovers new properties that may be of potential benefit in the treatment of atherosclerosis, hypertension, cholelithiasis, mild renal disease and possibly thrombogenesis and cancer. In view of the fact that the magnitude of low density lipoprotein cholesterol lowering is commensurate with the degree of atherosclerosis regression, HMG-CoA reductase inhibitors provide a unique tool for the control of aggressive atherosclerotic vascular disease and for secondary prevention of coronary artery disease.