HMG-CoA reductase inhibitors (statins) have dramatically improved the outcomes for the treatment of hypercholesterolaemia through the reduction of plasma lipoproteins. Although the mechanisms for this process are still under investigation, researchers have shown that competitive inhibition of the HMG-CoA reductase inhibitors in the liver promulgates the reduction of cholesterol produced by the liver. In addition, research also demonstrates that HMG-CoA reductase inhibitors upregulate hepatic low-density lipoproteins (LDL) prompting the reuptake of LDL by the liver. The end result of this entire process is a reduction of plasma LDL-cholesterol levels by approximately 30 percent in most cases.
Despite the fact that HMG-CoA reductase inhibitors have produced marked results for lowering LDL cholesterol and have been reported to be well tolerated by patients research on these drugs demonstrates the there is some concern about when to initiate therapy. Although some experts contend that these drugs should be used aggressively to stop the onset of more serious cardiac complications, others contend that a more relaxed “wait-and-see” approach to the use of these drugs is appropriate. With the realization that so much controversy exists over when to initiate statin therapy, there is an impetus to explore the current literature on the subject and draw some conclusions about the best choice for when to initiate therapy. To this end, this investigation considers what researchers have noted about the initaitation of HMG-CoA reductase inhibitors and the overall benefits and drawbacks to treatement.