Review: Lipid lowering drugs,inflammation and cardiovascular disease

Abstract

Inflammation is an integral part of atherosclerosis, both in its early phases and in acute coronary syndromes. Markers of inflammation, especially C-reactive protein (CRP) are increasingly recognised as predictors of cardiovascular events. At the same time, evidence is growing that the statins have anti-inflammatory properties which may at least in part be independent of their effect on lipids. Statins can rapidly lower levels of CRP and this may be paralleled by changes in cardiovascular risk which precede reductions in serum cholesterol levels. This therefore represents an additional rationale for the use of statins in cardiovascular disease prevention, both primary and secondary. It must be noted that the fibrates also possess anti-inflammatory activity, although by different mechanisms: this has not been explored to the same extent as is the case for the statins. Equally, the statins may ultimately be useful in other forms of chronic inflammatory disease.