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Therapeutics/Prevention
Systematic review with meta analysis
With statin co-administration, drugs designed to increase HDL have no impact on cardiovascular outcomes
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  1. Paul N Durrington
  1. Cardiovascular Research Group, University of Manchester, Manchester, UK
  1. Correspondence to : Professor Paul N Durrington, Cardiovascular Research Group, University of Manchester, Core Technology Facility, 46 Grafton Street, Manchester M13 9NT, UK; pdurrington{at}manchester.ac.uk

https://doi.org/10.1136/ebmed-2014-110084

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    Commentary on: Keene D, Price C, Shun-Shin MJ, et al. Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117,411 patients. BMJ 2014;349:g4379.OpenUrlAbstract/FREE Full Text

    Context

    Decreasing low-density lipoprotein (LDL) cholesterol with statin treatment reduces cardiovascular disease (CVD) incidence. The National Institute for Health and Care Excellence (NICE) has recently recommended that first-line statin treatment in primary prevention should be atorvastatin 20 mg daily and in secondary prevention atorvastatin 80 mg daily, doses which typically decrease LDL cholesterol by 43% and 55%, respectively.1 In many patients this will leave little scope to reduce residual CVD risk by additional LDL lowering. Attention is therefore drawn to the epidemiological inverse association between HDL cholesterol and CVD risk. This is widely exploited in the …

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