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Primary prevention: a simple, effective means of risk reduction.

Individuals without overt coronary heart disease (CHD) may nevertheless be at significant risk for future CHD events based on lipid and other risk factors. Recognition of this fact is reflected in the inclusion of measures of global risk in current CHD prevention guidelines. Given the fact that many patients in the primary prevention setting fail to achieve target lipid levels, simplicity of treatment can be considered to be of great importance. Drug treatment that can improve achievement of low-density lipoprotein cholesterol (LDL-C) targets and produce beneficial effects on other lipid risk factors at starting doses would be of considerable utility in this setting. A new statin, rosuvastatin, has been shown to produce greater reductions in LDL-C and to permit more patients to reach target levels than currently available statins, and has also demonstrated favorable effects on other lipid variables. Rosuvastatin may thus be a prime candidate for use in clinical practice to achieve the lipid goals recommended in guidelines for primary prevention of CHD.