Abstract
Hyperecholesterolemia, i.e. elevated total and LDL-cholesterol, belongs to basic modifiable risk factors of atherosclerosis and cardiovascular disease. If the patient has high or very high total cardiovascular risk, pharmacological lipid modifying therapy should be introduced; the most effective drugs are right now statins.
Statin therapy is not used sufficiently. Statins are underdosed from many different reasons atributable to physician or patient.
Other lipid disorders are underdiagnosed, esp. atherogenic dyslipidemia, which represents residual lipid cardiovascular risk, esp. in patients with type 2 diabetes. Level of non-HDL cholesterol should be the secondary goal of dyslipidemia treatment.
Combined therapy of statin + fibrate or statin + ezetimibe are available to achieve that goal. While statin therapy is going up (75 % of all lipid modifying drugs), the use of fibrates (24 %) and ezetimibe (1 %) are stable.
The trend of lipid modifying therapy is fixed drug combination, which will be tailored for individual dyslipidemia and individual tolerance and drug effectiveness.