Should all patients with cardiovascular disease receive statin therapy?

Abstract

With the strong correlation between the development of coronary heart disease and elevated levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C), therapies that significantly lower lipid levels will be widely prescribed. Within the past 15 years, major studies have shown the statins to be very effective in lowering LDL-C levels. Are the effects of statin therapy powerful enough to justify administering one of these drugs to every patient with cardiovascular disease? Among the arguments favoring its general usage are its safety record, its high rate of patient compliance (especially in comparison to alternative therapies such as diet and exercise), and its cost effectiveness. On the other hand, elevated levels of LDL-C are not the only cause of atherosclerosis, so simply lowering the LDL-C level is not the sole answer to reducing the risk of mortality and morbidity from coronary heart disease.