Hypercholesterolemia; Management of Korean Patients in New Millennium / 대한내과학회지

ABSTRACT

Cardioprotective effect and the safety of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) has been established in many large-scaled randomized controlled trials encompassing both primary and secondary prevention. Therefore, the market of statins is growing rapidly. In new millennium, several studies have shown the benefit from further reducing already low concentration of low density lipoprotein-cholesterol in high-risk patients. However, these clinical trials have applied selection criteria to protect the internal validity at the expense of reducing the applicability of the trial's findings to the wider population of patients seen in routine clinical practice. Treatment guideline for Korean hypercholesterolemic patients followed that of American. However, the death rate by coronary artery diseases is much lower in Korean population than in American population. The efficacy of statins in preventing cardiovascular diseases and the pitfalls in recent randomized controlled trails will be reviewed and the personal opinion for the management of Korean hypercholesterolemic patients will be suggested.