New clinical and pharmacological aspects of the use of atorvastatin for primary and secondary prevention of complications of cardiovascular diseases

Abstract

The article discusses new data obtained in the course of several large observational studies evaluating the quality of prevention of cardiovascular diseases caused by atherosclerosis in the modern population. It also considers the the problem of insufficiently frequent use of lipid-lowering drugs in modern clinical practice. New data are presented on the benefits of using statins, in particular atorvastatin, for the purpose of not only secondary, but also primary prevention, as well as the preservation of the efficacy and safety of statin therapy over a long period. Possible benefits of using atorvastatin are discussed, including the possibility of more rapid achievement of the clinical effect that was reported during the randomized controlled clinical trial, which can play a role in the choice of certain statins in certain clinical situations. The recently published results of the analysis of data on the subjects of the ASCOT-LLA (Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm) study, which were obtained with long-term follow-up, are discussed. The article considers the new data on the probably excessively conservative approach to the selection of target levels of low-density lipoprotein cholesterol in the blood that were obtained during the large observational studies. The modern concept of “primary prevention” of cardiovascular diseases caused by atherosclerosis is considered. The recent data presented in the article include the features of the use of atorvastatin in clinical practice, which may be an additional reason for increasing the frequency of its use in clinical practice for the purpose of both secondary and primary prevention.