The role of combined lipid-lowering therapy (rosuvastatin/ezetimibe) in the treatment of cardiovascular diseases caused by atherosclerosis

Cardiovascular diseases are the leading cause of death in the world. Moreover, mortality from them increases annually, and the main portion is caused by atherosclerotic disease. The high prevalence of heart disease in the world is due to the presence of a number of risk factors in patients. In addition to well-known diseases such as high blood pressure, diabetes mellitus, smoking, physical inactivity, and obesity, hyperlipidemia also plays an important role in the development of atherosclerotic disease. Thus, people with elevated levels of low-density lipoprotein cholesterol have a 2-fold higher risk of developing atherosclerotic disease than people with normal levels. Therefore, as preventive measures in the fight against this disease, it is necessary to control not only such diseases as overweight, smoking, alcohol, physical inactivity, hyperglycemia, high blood pressure, but also hypercholesterolemia. As drugs aimed at preventing the development of atherosclerotic disease and related complications, statins are the most studied drugs used in primary and secondary prevention. However, when using statins, approximately 1/3 of patients reach the target cholesterol level. In addition, sometimes side effects may develop (although very rarely), including myopathy and rhabdomyolysis, new cases of diabetes. To increase the frequency of reaching the target level of cholesterol and reduce the risk of side effects, it is recommended to use a combination of lipid-lowering drugs with a synergistic mechanism of action, and prescribe them in the one tablet. Such a combination is statin + ezetimibe, a drug that prevents the reabsorption of cholesterol in the intestine. Rosuvastatin, which has the highest lipid-lowering effect, is recommended as a statin. The combination of rosuvastatin+ezetimibe has shown an advantage over statin monotherapy in terms of lowering low-density lipoprotein cholesterol cholesterol and reducing the development of side effects