The past decades have seen evidence accumulate in favor of ever lower LDL cholesterol goals. Some worry that there is a point at which the harm of a low LDL may overtake the benefits. Additionally, newer agents are needed to help achieve these low levels of LDL and to help raise HDL. This chapter reviews some of the trends and future directions in the management of hyperlipidemia.
How Low Do You Go?
The Heart Protection Study showed that, regardless of the effect on lipid levels, statin therapy has benefits in all patients with known disease and in those patients at high risk who do not as yet have clinical manifestations of atherosclerotic vascular disease . Other studies such as the PROSPER Trial also suggested the benefits of statin therapy in primary and secondary prevention regardless of the effect on lipid levels. Several investigators began to suggest that we should abandon the concept of titrating the intensity of our treatment to achieve a specific LDL level...
KeywordsFamilial Hypercholesterolemia Microsomal Triglyceride Transfer Protein Behavioral Health Provider High Dose Statin Therapy Transfer Protein Inhibitor
- 1.Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of Cholesterol Lowering in 20,536 high-risk individuals: a randomized placebo controlled trial. Lancet 2002;360:7–22.Google Scholar
- 3.Sever PS, Dahlof B, Poulter NR, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower than average cholesterol concentrations in the Anglo-Scandinavian Cardiac Outcomes Trial–Lipid Lowering Arm (ASCOT-LLA). Lancet 2003;361:1149–1158.PubMedCrossRefGoogle Scholar