¿Hasta dónde hay que reducir el colesterol en el paciente de alto riesgo cardiovascular?

When subjects with low LDL cholesterol levels have the same absolute risk (due to other associated risk factors) as those with elevated LDL cholesterol levels, the same benefit is obtained for each mg/dl of reduction in LDL cholesterol level. In recent trials of intense treatment with statins, no side effects derived from the reduction of LDL cholesterol obtained have been observed. The hypothesis of the lower the level of LDL cholesterol, the better has been ratified by the results of important trials, as manifested by the HPS and CARDS results. As statins have become more widely used, their effects have been emerging and these go beyond the decrease of cholesterol, the so-called pleiotropic effects of them: improvement of endothelial dysfunction, increase of bioavailability of nitric oxide, antioxidant effects, anti-inflammatory effects and stabilization of atherosclerotic plaque.