Helena Gylling

Clinical experience: studies with HMG-CoA reductase inhibitors

Before the hydroxy-methyl glutaryl CoA (HMG-CoA) reductase inhibitor (statin) era, it was known from animal experiments and from human angiographic studies that lowering of serum total and LDL cholesterol levels is followed by regression of atherosclerotic lesions in arteries [1]. It was also shown in humans that with extensive dietary and lifestyle changes it was possible to reduce the most important clinical outcome, coronary morbidity and mortality [2, 3, 4, 5]. In addition, similar results were obtained with a couple of large-scale drug interventions with cholestyramine [6] and nicotinic acid [7]. On the basis of these studies, it could be anticipated that atherosclerosis is a reversible disease.