Future directions in lipid therapies.
Cholesterol management to reduce the burden of cardiovascular disease is a major public health concern. Despite widespread recognition of lipid abnormalities as cardiovascular risk factors, significant cardiovascular event reductions with cholesterol-lowering therapies, and dissemination of treatment guidelines, most high-risk patients are not at target lipid levels. In addition to lifestyle changes, four major drug classes are available to modify lipid levels: fibrates, niacin, resins, and statins. High efficacy and tolerability in clinical trials make statins the most widely prescribed of these agents. Newer, more potent members of this class and novel formulations of niacin and resins may provide more effective therapy for dyslipidemia with fewer side effects. Several agents in development (cholesterol-absorption inhibitors and ACAT inhibitors) exploit mechanisms of action complementary to those of current treatments and combined with statins may produce greater improvements in lipid profiles than are now possible. These innovations should enable a greater number of patients to achieve more aggressive cholesterol goals, thereby reducing the risk of cardiovascular events.
Ansell
Benjamin
B
UCLA Center for Primary Care-Based Cardiovascular Disease Prevention, Los Angeles, California 90095, USA.
D001161:Arteriosclerosis / Q000209:etiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000517:prevention & control; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000209:etiology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008019:Life Style; D050356:Lipid Metabolism; D008055:Lipids / Q000009:adverse effects*; D008074:Lipoproteins / Q000009:adverse effects / Q000378:metabolism; D012307:Risk Factors
D000960:Hypolipidemic Agents; D008055:Lipids; D008074:Lipoproteins