Beneficial Pleiotropic Effects of Statins

Background: Statins are recognised as the most effective lipid-lowering drugs. The main mechanism of action is the inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, which is a key enzyme in the cholesterol synthesis pathway Statins also have additional effects, known as pleiotropic effects, which are mostly due to the inhibition of the formation of non-steroidal isoprenoids. The latter have important functions in the activation of many intracellular signalling pathways. Consequently, statins improve endothelial function, have anti-inflammatory and immunomodulatory activity, act as antioxidants, stabilize atherosclerotic plaques and influence haemostasis and thrombosis. The described mechanisms are particularly relevant in the protective activity of statins on the cardiovascular system, central nervous system, kidneys and many other organs. Conclusions: In the current article we review the pharmacological mechanisms of action, which contribute to the beneficial pleiotropic effects of statins. Described mechanisms are supported by the evidence obtained from clinical trials in the last decade.