The presented expert paper discusses the high prevalence of hypercholesterolemia (HCH) in Russia. Insufficient use of lipid-lowering therapy in both primary and secondary prevention is indicated. Failure to achieve the target level of low-density lipoprotein cholesterol (HC) and low adherence (especially long-term) of patients to hypolipidemic drugs remains a serious problem in real clinical practice. Statins are a class of widely prescribed lipid-lowering drugs that are the first choice drugs in the treatment of HCV and combined hyperlipidemia (GLP) with proven efficacy in the prevention of atherosclerotic cardiovascular diseases. Using the example of the original pitavastatin, this expert document convincingly demonstrates the drug's capabilities not only in reducing atherogenic lipids and lipoproteins in blood plasma, but also its clinical effectiveness in the primary and secondary prevention of cardiovascular complications. This highlights the unique effect of pitavastatin on increasing low cholesterol levels of high-density lipoproteins, proven anti-atherosclerotic activity and a wide range of positive pleiotropic effects that enhance its antiatherogenic effect. The low risk of drug interactions inherent in pitavastatin highlights its high safety with prolonged use and good tolerability. All of the above gives grounds to consider the original pitavastatin as the drug of choice for a wide range of patients. © Eco-Vector, 2025.