What evidence do we have that statin agents’ effects are not anti-inflammatory and not related to lipid lowering? Everyone gets a 30% reduction in mortality risks no matter what their level of LDL. This is in addition to large studies’ findings in which 135,000 patients who were treated with coronary interventions in hospitals averaged an LDL of 105. Many coronary patients have normal lipids, so is the real benefit of statins their anti-inflammatory benefits?—PAUL BATTLE, PA-C, Denver, Colo.

The anti-inflammatory action of statins is recognized as one of the most effective treatments for atherosclerosis and lowering of cardiovascular risk. More recent experimental and clinical investigations have indicated that statins can exert a number of cholesterol-independent, cardioprotective actions. Because nitric oxide derived from endothelial nitric oxide synthase (eNOS) represents a highly potent anti-inflammatory signaling pathway, the investigation of statins as anti-inflammatory agents is very logical and a path of continued research. After the landmark finding that statins upregulate eNOS function, a number of studies have reported very powerful anti-inflammatory actions of statins that are largely related to eNOS-dependent activity.—ABIMBOLA FARINDE, PhD, PharmD, Orange Beach, Ala. (205-5)


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