Hypercholesterolemia

Since statins were introduced in the treatment of hypercholesterolemia, the rate of adverse outcomes has been significantly reduced. Large-scale randomized clinical trial evidence shows that the vast majority of patients do well with statin therapy without adverse events.[133]Newman CB, Preiss D, Tobert JA, et al; American Heart Association Clinical Lipidology, Lipoprotein, Metabolism and Thrombosis Committee, a Joint Committee of the Council on Atherosclerosis, Thrombosis and Vascular Biology and Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council. Statin safety and associated adverse events: a scientific statement from the American Heart Association. Arterioscler Thromb Vasc Biol. 2019 Feb;39(2):e38-81. https://www.ahajournals.org/doi/full/10.1161/ATV.0000000000000073?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed http://www.ncbi.nlm.nih.gov/pubmed/30580575?tool=bestpractice.com [134]Collins R, Reith C, Emberson J, et al. Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet. 2016 Nov 19;388(10059):2532-61. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31357-5/fulltext http://www.ncbi.nlm.nih.gov/pubmed/27616593?tool=bestpractice.com Cases of myopathy and any muscle-related symptoms associated with statin therapy generally resolve after discontinuation of treatment. If the treatment plan includes detection and management of other factors that contribute to the development of coronary heart disease (CHD), such as hypertension, diabetes mellitus, and smoking, the overall prognosis of hypercholesterolemia is improved. Cholesterol reduction is useful as a CHD risk-reduction strategy and for primary prevention in people who are at high risk for CHD or other forms of atherosclerosis.