Extract

Cholesterol lowering with statin therapy has been shown to reduce cardiovascular events in a variety of patient categories, ranging from patients with established cardiovascular disease to high-risk individuals with no previous history.1 The degree of benefit relates primarily to a patient's absolute risk of cardiovascular events and to the absolute reduction in low-density lipoprotein (LDL)-cholesterol. The optimal intensity of lipid-lowering therapy has been the focus of recent clinical trials, with growing support in the cardiovascular community for the concept of ‘the lower the better’ for LDL-cholesterol. As a result, the target for LDL-cholesterol has been adjusted for patients at moderate or high risk of cardiovascular events.2 Prolonged statin treatment with a significant reduction in LDL-cholesterol has also been strongly recommended.1 Sever and colleagues have presented the results of a 2-year extension of the Anglo-Scandinavian Cardiac Outcomes Trial lipid-lowering arm (ASCOT-LLA Extension).3

In the initial ASCOT trial, the blood pressure-lowering arm (ASCOT-BPLA) compared the effect of two different antihypertensive regimens on cardiovascular outcomes. ASCOT-LLA was a double-blind, placebo-controlled trial of atorvastatin 10 mg/day in patients enrolled in ASCOT-BPLA who had total cholesterol ≤6.5 mmol/L.

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