Pleiotropic effects of statins: moving beyond cholesterol control.

3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors or "statin" medications are the most commonly prescribed therapy for lowering cholesterol. In use for over a decade, they have demonstrated both safety and tolerability across a broad range of patients. The ability to inhibit the biosynthesis of cholesterol and reduce low-density lipoprotein cholesterol levels is known to play a major part in reducing cardiovascular risk. Multiple clinical trials have cemented their role in both primary and secondary prevention of atherosclerotic disease. Clinical evidence also supports the principle that reductions in cardiovascular risk are interdependent on mechanisms beyond cholesterol reduction alone. These pleiotropic effects of statins have underscored a widening focus and understanding into the mechanisms of vascular dysfunction, inflammation, and injury. They have also brought a new perspective to a broad spectrum of clinical uses that has implications for specialties as varied as infectious disease, rheumatology, and oncology.