Long-and-short term trials with the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have demonstrated significant reductions in cardiovascular and cerebrovascular events in patients with and without preexisting heart disease. Beyond improving the lipid profile, statins have additional effects that may contribute to their overall clinical benefit. Statin treatment appears to reduce global risk profile by affecting both novel and established lipid, inflammatory, and morphologic markers including low-density lipoprotein subclasses, lipoprotein (a), markers of endothelial function, inflammatory mediators, intima-media thickening, and coronary calcification. Although statins may be regarded as a rather homogeneous drug class in terms of biological activity, some agents feature unique properties that have beneficial effects on selected important risk matters.