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NDT Advance Access originally published online on August 31, 2004
Nephrology Dialysis Transplantation 2004 19(11):2696-2699; doi:10.1093/ndt/gfh472
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Nephrol Dial Transplant Vol. 19 No. 11 © ERA-EDTA 2004; all rights reserved

Editorial Comment

Intensive treatment with statins and the progression of cardiovascular diseases: the beginning of a new era?

Jose Tuñón1, Luis Miguel Blanco-Colio2, Jose Luis Martín-Ventura2 and Jesús Egido2

1 Department of Cardiology and 2 Vascular Research Laboratory, Fundación Jiménez Díaz, Autónoma University, Madrid, Spain

Correspondence and offprint requests to: Professor Jesús Egido, Renal and Vascular Laboratory, Fundación Jiménez Díaz, Avenida Reyes Católicos 2, 28040 Madrid, Spain. Email: jegido@fjd.es

Keywords: cardiovascular diseases; intensive treatment; statins

The first 10% of the full text of this article appears below.



   Introduction
 
Statins represent one of the major therapeutic revolutions in the modern era of cardiovascular medicine. However, the advent of these drugs has not only afforded solutions, but has also raised new questions. Perhaps the most intriguing one is: how much low-density lipoprotein (LDL) reduction must we achieve to obtain the greatest benefits? From a theoretical point of view, Grundy [1] discussed three different possibilities. The first one was that below a threshold LDL level, no further benefit was obtained. The second was that decreasing LDL levels would continue to yield proportional cardiovascular risk reduction. The third hypothesis was that the benefit achieved progressively decreased as LDL levels did, without a clear cut-off point.

Henceforth, classic reports suggested that people with spontaneously low cholesterol levels were at low risk for coronary events [2,3]. However, it was necessary to demonstrate subsequently that achieving such low . . . [Full Text of this Article]



   Early trials
 


   Recent trials
 


   Why is intensive lipid-lowering more effective?
 


   Clinical implications and the future
 

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