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QJM Advance Access originally published online on July 20, 2009
QJM 2009 102(11):817-820; doi:10.1093/qjmed/hcp099
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© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Primary prevention of cardiovascular disease with statins: cautionary notes

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

Sir,

In his informative commentary on the importance of primary prevention in reducing the burden of vascular disease,1 Dr Miller states that compliance problems with lifestyle changes facilitate the pharmacologic treatment with statins to achieve low-density lipoprotein (LDL) cholesterol lowering goals. It's noteworthy that prominent thought leaders now suggest that 100 million Americans should be on statin therapy (instead of the 16 million Americans presently on statin therapy) and everyone should have a LDL cholesterol level <100 mg/dl for the primary prevention of vascular disease.2,3 However, there are potential problems with the long-term use of statins, which have been inadequately evaluated in the relatively short-term prevention trials.

It is interesting that in vitro studies have shown statins to exhibit anti-proliferative, pro-apoptotic, anti-invasive and radio-sensitization properties mediated by a statin induced reduction in mevalonate and downstream geranylgeranylated proteins.4,5 These pleiotropic effects of statins . . . [Full Text of this Article]

M.R. Goldstein

Fountain Medical Court Bonita Springs FL, USA

L. Mascitelli

Comando Brigata alpina "Julia" 8 Via S. Agostino Udine 33100 Italy email: lumasci@libero.it

F. Pezzetta

Ospedale di Tolmezzo Tolmezzo, Italy


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