Lovastatin and beyond: the history of the HMG-CoA reductase inhibitors

Nat Rev Drug Discov. 2003 Jul;2(7):517-26. doi: 10.1038/nrd1112.


In the 1950s and 1960s, it became apparent that elevated concentrations of plasma cholesterol were a major risk factor for the development of coronary heart disease, which led to the search for drugs that could reduce plasma cholesterol. One possibility was to reduce cholesterol biosynthesis, and the rate-limiting enzyme in the cholesterol biosynthetic pathway, 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase, was a natural target. Here, I describe the discovery and development of lovastatin--the first approved inhibitor of HMG-CoA reductase--and the clinical trials that have provided the evidence for the ability of drugs in this class to reduce the morbidity and mortality associated with cardiovascular disease.

Publication types

  • Review

MeSH terms

  • Animals
  • Drug Design
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Lovastatin / adverse effects
  • Lovastatin / pharmacology
  • Lovastatin / therapeutic use*


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lovastatin