| guest editorial
International Journal of Aesthetic and Anti-Ageing Medicine Informa Healthcare, Telephone House 69-77 Paul Street, London, EC2A 4LQ, UK
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substances have different effects on the lipid profile, such as the ability to increase certain parameters, or to change the ratio between large and small density particles. in general, however, they positively influence dyslipidaemia (the only exception being bile acid sequestrants). it could be concluded, therefore, that the more suitable term is ‘anti-dyslipidaemic drugs’, but this was never adopted in clinical practice. almost 20years after the first discovery, it was found that the beneficial effects of statins on morbidity and
T
mortality are also present in patients with low levels of ldl cholesterol. These findings raised two questions: what are the physiological levels of ldl cholesterol? and do effects — other than lipid-modifiable effects — exist, which could be responsible for a decrease in morbidity and mortality? The answer is ‘yes’, and they are possibly even more important than the lipid-lowering effects. it was confirmed that many of the beneficial effects of statins cannot be explained simply by the lowering of atherogenic lipids alone. non-lipid modifiable statin effects are associated with metabolic pathways influenced by statin therapy. statins decrease not only the synthesis of mevalonate and subsequently of cholesterol, but they also decrease synthesis of other substances — significantly, those associated with inflammatory processes and proliferation. interestingly, atherosclerosis is an inflammatory-degenerative-proliferative disease, and statins have the ability to influence all compounds of this process, so (with a little exaggeration) a more suitable name for statins could be ‘anti-atherosclerotic drugs’. when results of the reversal and asTeroid studies are taken into account, then this isn’t such a huge exaggeration. when prescribing statins, it is important that the physician considers the patient and the degree of
cardiovascular risk. current european and american guidelines recommend statin therapy not only for primary or secondary prevention of atherosclerosis, but also to type 2 diabetes patients, and patients with moderate- to high-risk arterial hypertension. furthermore, benefits have been observed in patients with normal ldl cholesterol, but also increased high-sensitivity c-reactive protein, as shown in the JuPiTer trial. Therefore, the number benefiting from statin therapy could be even higher. More recent clinical studies focus on stabilisation of the atherosclerotic process (inhibitors of lipoproteins associated with phospholipase a2), and the modulation of vascular inflammation (antibodies against interleukin-1 β). statins are prescribed for atherosclerosis in the same way that chemotherapy
is prescribed for cancer. The benefits of statins are responsible for prolonging life and increasing its quality. in this way, they could be considered as the most typical anti-ageing medicine in cardiology.
Professor Daniel Pella
department of Medicine, l. Pasteur university hospital and Medical faculty PJ Šafárik university, slovakia; vice-President wosiaM
priMe journal editorial board Board MeMBer Dr Wilmar Accursio Dr Ashraf Badawi
SpecialiSM
Dr Claude Dalle Dr Pierre Andre
Dr Janethy Balakrishnan Dr Lakhdar Belhaouari Dr Philippe Berros Dr Dario Bertossi
Dr Jean Christophe Bichet
Anti-ageing & aesth. medicine France Endocrinologist Dermatology Dermatology Dermatology Plastic surgery
France Egypt
Malaysia France
Oculoplastic surgery Maxillofacial surgery Plastic surgery
Dr Philippe Blanchemaison Phlebology Dr Pierre Bouhanna Dr Fahd Benslimane Prof Wayne Carey
Dr Claude Chauchard Dr Olivier Claude
Dr Christophe de Jaeger Prof Ilaria Ghersetich Dr Monika Golkova Dr Raul Gonzalez Prof Eckart Haneke Dr Steven Hopping Prof Xiaoyan Jiang
Prof Andreas Katsambas
Dermatology – Hair surgery Plastic Surgeon Dermatology
Anti-ageing medicine Plastic surgery Geriatrics
Dermatology Neurologist
Plastic surgery Dermatology Plastic surgery Genetics
Dermatology
Monaco Italy
France France France
Morocco Canada France France France Italy
Czech Republic Brazil
Germany USA
Canada Greece
country Brazil
Board MeMBer Dr Mario Krause
Dr Ching Lai
Dr Marina Landau Dr Jean-Luc Levy Dr Sohail Mansoor Prof Leonardo Marini Dr Georges Mouton Dr Ruben Muhlberger Prof Daniel Pella Dr Vincenzo Penna
Prof Ascanio Polimeni Dr Herve Raspaldo Dr Constantin Stan Dr Pakpilai Thavisin Dr Mario Trelles Dr Ines Verner Dr Octavio Viera
Prof Bernard Weber Prof Alfred Wolf Christophe Luino Catherine Decuyper
SpecialiSM
Anti-ageing medicine Anti-ageing medicine Dermatology Dermatology Dermatology Dermatology
Sports medicine
Anti-ageing medicine Cardiology
Dr Chariya Petchngaovilai Dermatology Dr Eric Plot
Plastic surgery Plastic surgery
Neuro-endocrinology Facial plastic surgery Plastic surgery
Anti-ageing medicine; pediatry Genetician
Gynaecology
Industry expert & consultant Industry expert & consultant
country Germany
Hong Kong Israel
France UK
Italy Belgium
Argentina Slovakia Germany Thailand France Italy
France
Dermatology & Anti-ageing medicine Thailand Plastic surgery Dermatology
Israel Spain
Luxembourg Germany France France
prime-journal.com | September 2011 ❚ 5
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he firsT sTaTin was discovered in 1976. iniTially They were used only in cardiology, but are now also used in angiology, diabetology, nephrology, and neurology — and the spectrum of indications continues to grow. statins were primarily used for the treatment of hypercholesterolaemia in secondary prevention of atherosclerosis. Belonging to the group of lipid-lowering drugs, in only a few years after their discovery they overpowered all others. whether the term ‘lipid-lowering drug’ is appropriate has often been debated, as these
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