Overview of prevention and treatment of atherosclerosis with lipid-altering therapy for pharmacy directors.

Cardiovascular (CV) disease is the leading cause of mortality and one of the leading causes of disability worldwide. Its economic burden is enormous, and the estimated direct and indirect costs of the disease in 2006 exceeded $400 billion. Low-density lipoprotein cholesterol is recognized as a major cause of coronary heart disease and other clinical forms of atherosclerotic disease, and an elevated low-density lipoprotein cholesterol level remains the primary target of lipid-lowering therapy. Recent retrospective evidence points to deficiencies in the management of patients with atherosclerosis in the clinical practice setting. Enhancing awareness of the need to monitor and treat dyslipidemia in atherosclerosis, and of the benefits of such treatment reported in recent studies, may help to narrow this treatment gap. This review will examine the development of atherosclerosis and the role atherosclerosis plays in the underlying pathophysiology of CV disease. Imaging methods for assessing progression of atherosclerosis and new recommendations for risk-reduction therapy in patients with established atherosclerotic vascular disease are discussed. Emphasis is on newer data regarding the effect of statins in retarding progression of atherosclerosis or even inducing regression of atherosclerosis.