Clinical & Experimental Cardiology
Open Access

Abstract

Treatment of Hypercholesterolemia

Wilbert S Aronow

Numerous randomized, double blind, placebo-controlled studies and observational studies have shown that statins reduce mortality and major cardiovascular events in high-risk patients with hypercholesterolemia. The Heart Protection Study showed that statins reduced mortality and major cardiovascular events in high-risk patients regardless of the initial level of serum lipids, age, or gender. The updated National Cholesterol Education program III guidelines state that in very high-risk persons, a serum low-density lipoprotein (LDL) cholesterol level of <70 mg/L is a reasonable clinical strategy. For moderately high-risk persons ( 2 or more risk factors and a 10-year risk for coronary artery disease of 10% to 20%), the serum LDL cholesterol should be reduced to <100 mg/dL. When LDL cholesterol-lowering drug therapy is used to treat high-risk persons or moderately high-risk persons, the serum LDL cholesterol should be reduced at least 30% to 40%. The serum LDL cholesterol should be decreased to less than 160 mg/dl in persons at low risk for cardiovascular disease. Addition of other lipid-lowering drugs to statin therapy has not been found to further reduce cardiovascular events and mortality.