Achievement of low-density lipoprotein cholesterol goals: new strategies to address new guidelines.
Evidence that CHD morbidity and mortality can be reduced with reduction of LDL-C to less than 100 mg/dL (2.6 mmol/L) is rapidly accumulating. NCEP-ATP III guidelines should be considered minimal goals of therapy. Regarding the prevention and treatment of CHD, health care providers need to recognize the wide therapeutic gap between evidence-based medicine and customary clinical practice. Aggressive pharmacologic therapy is probably required to achieve optimal LDL-C levels in many hyperlipidemic patients. Novel agents, including selective cholesterol absorption inhibitors, will provide clinicians with a tool to safely and effectively target the exogenous pathway of cholesterol metabolism. Combination therapy with cholesterol-lowering agents that have complementary mechanisms of action and can be safely co-administered may be a new option to achieve broader lipid control.
Illingworth
D Roger
DR
Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine (L465), Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. illingwo@ohsu.edu
D008078:Cholesterol, LDL / Q000097:blood*; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D017410:Practice Guidelines as Topic
D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents