Statin therapy: is the percent reduction or the attained low-density lipoprotein cholesterol level more important?

Hyperlipidemia is a well-known risk factor for atherosclerosis. Several trials have demonstrated the importance of lowering low-density lipoprotein cholesterol (LDL-C) levels to reduce all-cause mortality, coronary ischemia, and cerebrovascular accidents. Although the optimal goal for LDL-C levels in patients with known coronary heart disease has been less than 100 mg/dL, more recent findings support achieving even lower LDL-C levels for very high-risk patients. As the target levels for LDL-C trend towards lower values, it is important to evaluate the status for optimal management with statin therapy. In this review article, we discuss the role of percent LDL-C reduction versus attained LDL-C levels as targets for statin therapy in order to maximize the preventive care provided to high-risk patients.