Editing Atherosclerosis (section)

===Statins===
[[Statin]] medications are widely prescribed for treating atherosclerosis. They have shown benefit in reducing cardiovascular disease and mortality in those with [[high cholesterol]] with few side effects.<ref>{{cite journal | vauthors = Taylor F, Huffman MD, Macedo AF, Moore TH, Burke M, Davey Smith G, Ward K, Ebrahim S | title = Statins for the primary prevention of cardiovascular disease | journal = The Cochrane Database of Systematic Reviews | volume = 2013 | issue = 1 | pages = CD004816 | date = January 2013 | pmid = 23440795 | pmc = 6481400 | doi = 10.1002/14651858.CD004816.pub5 }}</ref> Secondary prevention therapy, which includes high-intensity statins and aspirin, is recommended by multi-society guidelines for all patients with a history of ASCVD (atherosclerotic cardiovascular disease) to prevent the recurrence of coronary artery disease, ischemic stroke, or peripheral arterial disease.<ref>{{cite journal | vauthors = Virani SS, Smith SC, Stone NJ, Grundy SM | title = Secondary Prevention for Atherosclerotic Cardiovascular Disease: Comparing Recent US and European Guidelines on Dyslipidemia | journal = Circulation | volume = 141 | issue = 14 | pages = 1121–1123 | date = April 2020 | pmid = 32250694 | doi = 10.1161/CIRCULATIONAHA.119.044282 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC, Sperling L, Virani SS, Yeboah J | title = 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines | journal = Journal of the American College of Cardiology | volume = 73 | issue = 24 | pages = e285–e350 | date = June 2019 | pmid = 30423393 | doi = 10.1016/j.jacc.2018.11.003 | hdl-access = free | hdl = 20.500.12749/1738 }}</ref> However, prescription of and adherence to these guideline-concordant therapies is lacking, particularly among young patients and women.<ref>{{cite journal | vauthors = Nanna MG, Wang TY, Xiang Q, Goldberg AC, Robinson JG, Roger VL, Virani SS, Wilson PW, Louie MJ, Koren A, Li Z, Peterson ED, Navar AM | title = Sex Differences in the Use of Statins in Community Practice | journal = Circulation. Cardiovascular Quality and Outcomes | volume = 12 | issue = 8 | pages = e005562 | date = August 2019 | pmid = 31416347 | pmc = 6903404 | doi = 10.1161/CIRCOUTCOMES.118.005562 }}</ref><ref>{{cite journal | vauthors = Lee MT, Mahtta D, Ramsey DJ, Liu J, Misra A, Nasir K, Samad Z, Itchhaporia D, Khan SU, Schofield RS, Ballantyne CM, Petersen LA, Virani SS | title = Sex-Related Disparities in Cardiovascular Health Care Among Patients With Premature Atherosclerotic Cardiovascular Disease | journal = JAMA Cardiology | volume = 6 | issue = 7 | pages = 782–790 | date = July 2021 | pmid = 33881448 | pmc = 8060887 | doi = 10.1001/jamacardio.2021.0683 }}</ref>

[[Statin]]s work by inhibiting HMG-CoA (hydroxymethylglutaryl-coenzyme A) reductase, a hepatic rate-limiting enzyme in cholesterol's biochemical production pathway. Inhibiting this rate-limiting enzyme reduces the body's ability to produce as much cholesterol endogenously, thereby reducing the level of LDL-cholesterol in the blood. This reduced endogenous cholesterol production triggers the body to then pull cholesterol from other cellular sources, enhancing serum HDL-cholesterol.{{citation needed|date=January 2021}} These data are primarily in middle-aged men and the conclusions are less clear for women and people over the age of 70.<ref>{{cite journal | vauthors = Vos E, Rose CP | title = Questioning the benefits of statins | journal = CMAJ | volume = 173 | issue = 10 | pages = 1207; author reply 1210 | date = November 2005 | pmid = 16275976 | pmc = 1277053 | doi = 10.1503/cmaj.1050120 }}</ref>