A current topic of hot debate in the medical field is the efficacy of cholesterol-lowering drugs in prolonging life. Lalitha Gopinath looks at the drugs available, and the evidence put forward to demonstrate their effectiveness 1. It forms part of a group of biological substances called sterols, which are solid alcohols that, like all alcohols, can form esters with fatty acids. Until recently, drug therapy for people with high blood cholesterol levels has been a subject of controversy in the medical field, mainly because clinical trials have failed to show sufficient evidence of improved survival after taking the drugs.
Cholesterol plays several vital roles in the body.
However, the role that draws more public attention is its part in the formation of atheromatous lesions in arterial walls, which constitute an underlying cause of coronary heart disease. Doctors use cholesterol-lowering drugs to treat hypercholesterolaemia when dietary modification has failed to bring the patient's level back down to normal. Table 1 shows various drugs on the market. Statins, niacin derivatives and resins are more effective in lowering LDL cholesterol than fibrates, but fibrates increase HDL cholesterol to a greater extent than the others. Statins, being the most recently developed of these drugs, present the greatest market opportunity in the industry and represent an important step forward in managing high blood cholesterol levels.