HMG CO Reductase inhibotor - woodywoodpecker

[ArchivalUser]

A 49-year-old male is found to have persistently elevated
total cholesterol and low-density lipoprotein (LDL) despite
lifestyle modification. You prescribe an HMG-CoA reductase
inhibitor to reduce the risk of coronary events. This medication
will exert all the following beneficial effects except
A. direct action on atheroma progression
B. improvement in endothelial-dependent vasomotion
C. long-term reduction of serum LDL
D. regression of existing coronary stenosis
E. stabilization of existing atherosclerotic lesions

[ArchivalUser]

BB?

[ArchivalUser]

DD?

[ArchivalUser]

ccc

[ArchivalUser]

The answer is D. HMG-CoA reductase inhibitors (œstatins) clearly reduce
cardiovascular events in patients with atherosclerosis. The mechanism appears to be
more complex than simply the reduction of serum LDL. Lipid-lowering drugs do not ap
pear to cause significant regression of fixed coronary lesions. The benefit of statins appears
to be related to stabilization of plaques, long-term egress of lipids, and/or improved
vasodilatory tone. The improved vasodilatory tone appears to be mediated by modulation
of endothelial-dependent vasodilators such as nitric oxide. Thus, the beneficial effect
of the statins probably consists of an early effect on vasomotion (or other mechanisms)
and a long-term effect on serum and plaque lipids.

[ArchivalUser]

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