Developing a clinical strategy for cholesterol management in an era of unanswered questions.
Recent clinical trials have supported the use of cholesterol-lowering therapies to reduce cardiovascular events. Despite these results, a number of unanswered questions remain, including the appropriate intensity of lipid-lowering therapy and the role of high-density lipoprotein cholesterol and/or triglycerides in cardiovascular risk assessment and reduction. In addition, the optimal treatment strategies for women, the elderly, and patients with diabetes are more difficult to determine, as these groups have comprised a minority of subjects in prior trials. Studies in progress will provide guidance toward effective treatment of these populations, the appropriate degree of lipid-lowering therapy, and the role of estrogen replacement therapy in postmenopausal women. In the interim, a clinical strategy incorporating the lessons of recent clinical evidence is suggested.
Ansell
B J
BJ
Center for Primary-Care Based Cardiovascular Disease Prevention, Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles School of Medicine, USA. bansell@mednet.ucla.edu
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000517:prevention & control*; D048909:Diabetes Complications; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides