Rosuvastatin as part of the primary prevention strategy against cardiovascular disease.

Patients with established cardiovascular disease (CVD) are the ones that are most commonly considered for therapeutic intervention in order to prevent progression of the disease. In contrast, patients without manifested CVD and at increased risk are often left untreated, even though they would have the greatest benefits from early risk reduction in terms of CVD prevention. According to the recently published European CVD prevention guidelines, the reduction of LDL cholesterol must be of prime concern in the prevention of CVD. With potent statins, such as rosuvastatin, we can achieve meaningful reductions of LDL cholesterol levels and, consequently, reduce an individual’s total CVD risk. On the basis of a large clinical study with rosuvastatin, prevention of major cardiovascular events in patients who are estimated to have a high risk was added to statin labels. A post hoc analysis of this clinical study which included only patients considered to be at high risk, showed that patients with a 10-year Framingham risk score of >20% or an estimated SCORE risk of >5% had statistically significant reductions, 50% and 43%, respectively, in the risk of MI, stroke, or cardiovascular death when treated with rosuvastatin compared with patients treated with placebo. Rosuvastatin also has established benefits in other high-risk patients, such as patients with diabetes and hypertension. Long-term compliance with statin therapy is critical for its efficacy in patients at high risk. With long-term statin treatment we can achieve greater reductions of the CVD risk and an even more pro- nounced regression of atherosclerotic plaques.