terapia hipolipemiante intensiva

Rev Méd Chile 2006; 134: 641-648

ARTÍCULOS DE REVISIÓN

Terapia hipolipemiante intensiva
en el manejo del riesgo
cardiovascular ateroesclerótico
Attilio Rigotti R1, Antonio Arteaga Ll2,Alberto Maiz G2.

Intensive cholesterol lowering
therapy to reduce cardiovascular risk
Primary and secondary prevention trials have clearly demonstrated
that lowering serum cholesterol levels withstatins reduces the incidence of cardiovascular events.
Recent studies plus post hoc analysis of previous clinical trials show that risk reduction is
proportional to the magnitude of LDL cholesterollowering. Therefore, new recommendations of
the National Cholesterol Education Program (USA) have defined a category of patients with very
high cardiovascular risk, who should achieve serum LDLcholesterol levels below 70 mg/dl. This
proposal will require new and more efficient pharmacologic strategies to attain the increasingly
strict therapeutic goals for LDL cholesterol. This article reviewsthe clinical studies that support the
use of intensive lipid lowering therapy to reduce cardiovascular risk. An effective reduction of
serum cholesterol can be obtained using statins in high dosesor a combination of hypolipidemic
drugs with different mechanisms of action (Rev Méd Chile 2006; 134: 641-8).
(Key words: Hydroxymethylglutaryl-CoA reductase inhibitors; Hypercholesterolemia)Recibido el 17 de agosto, 2005. Aceptado el 20 de octubre, 2005.
Departamentos de 1Gastroenterología y 2Diabetes, Nutrición y Metabolismo, Facultad de
Medicina, Pontificia Universidad Católica de Chile;Santiago, Chile.

L

a enfermedad cardiovascular coronaria y cerebrovascular isquémica constituyen la primera
causa de mortalidad en Chile1. Dentro de las
múltiples condiciones predisponentes, lahipercolesterolemia es un factor de riesgo claramente
establecido que favorece el desarrollo de ateroesclerosis. De acuerdo con la Encuesta Nacional de
Salud 2003, un tercio de la población...