Abstract
The main goal of lipid-lowering therapy is to reduce mortality and morbidity due to cardiovascular events of atherosclerotic origin or to reduce the risk of acute pancreatitis. Thanks to well established and modern laboratory methods, we also have the possibility to monitor the effectiveness of this treatment.
In addition, reliable data are available which confirm the impact of favorable and safe effect of aggressive reduction of LDL cholesterol, especially in high-risk individuals. In this population, the ideal LDL cholesterol levels should be lower than 1.3 mmol/l.
Recently very efficient drugs are available, making this goal achievable. Another goal of therapy are higher triglycerides and lower HDL cholesterol.
These parameters could be most effectively managed by lifestyle measures and in this case, pharmacotherapy is less successful. In this review we will focus on treatments affecting primarily LDL cholesterol, and potentially affecting favorably also levels of triglycerides and HDL cholesterol.
The mainstays of therapy are statins and their combination with ezetimibe. In non-respondents at high risk, LDL apheresis or inhibitors of proprotein convertase subtilisin/kexin 9 could be of value.