lipid-lowering drugs

Disclaimer: While every attempt is made to ensure that drug dosages provided within the text of this journal and the website are accurate, readers are urged to check drug package inserts before prescribing. Views and opinions in this publication and the website are not necessarily endorsed by or reflective of those of the publisher.

Wilbert S. Aronow, MD, FACC, FAHA, AGSF, Department of Medicine, Divisions of Cardiology, Geriatrics, and Pulmonary/Critical Care, New York Medical College, Valhalla, NY, USA.

Randomized, double-blind, placebo-controlled studies and observational studies have documented that statins reduce mortality and major cardiovascular events in high-risk persons with hypercholesterolemia. The Heart Protection Study showed that statins reduced mortality and major cardiovascular events in high-risk persons regardless of the initial level of serum lipids, age, or gender. The updated National Cholesterol Education Program (NCEP) III guidelines state that in very-high-risk patients, a serum low-density lipoprotein (LDL) cholesterol level of <1.81 mmol/L (<70 mg/dL) correct is a reasonable clinical strategy, regardless of age. When a high-risk person has hypertriglyceridemia or low serum high-density lipoprotein cholesterol, consideration can be given to combining a fibrate or nicotinic acid with an LDL cholesterol–lowering drug. For moderately high-risk persons, the serum LDL cholesterol should be reduced to <2.59 mmol/L 2.59 (<100 mg/dL). When LDL cholesterol–lowering drug therapy is used to treat high-risk persons or moderately high-risk persons, the serum LDL cholesterol should be reduced by at least 30–40%. High-risk older persons should be treated with lipid-lowering drug therapy according to NCEP III updated guidelines to reduce cardiovascular morbidity and mortality. The LDL cholesterol should be reduced to <4.14 mmol/L (<160 mg/dL)correct in persons at low risk for cardiovascular disease.
Key words: lipids, statins, lipid-lowering drugs, atherosclerotic vascular disease.

Wilbert S. Aronow, MD, Department of Medicine, Cardiology, Geriatrics, and Pulmonary/Critical Care Divisions, New York Medical College, Valhalla, NY, USA.

Randomized, double-blind, placebo-controlled studies and observational studies have demonstrated that statins reduce mortality and major cardiovascular events among high-risk older adults with hypercholesterolemia. The Heart Protection Study showed that statins reduced mortality and major cardiovascular events in high-risk persons regardless of the initial level of serum lipids, age, or gender. The updated National Cholesterol Education Program (NCEP) III guidelines state that among very high-risk patients a serum LDL cholesterol level of less than 70 mg/dl (1.8 mmol/l) is a reasonable clinical strategy, regardless of age. When a high-risk person has hypertriglyceridemia or low serum HDL cholesterol, consideration can be given to combining a fibrate or nicotinic acid with an LDL cholesterol-lowering drug. For moderately high-risk persons (having two or more risk factors and a 10-year risk for CHD of 10-20%) the serum LDL cholesterol should be reduced to less than 100 mg/dl (2.6 mmol/l). When LDL cholesterol-lowering drug therapy is used to treat high-risk persons or moderately high-risk persons, the serum LDL cholesterol should be reduced at least 30-40%.
Key words: lipids, statins, lipid-lowering drugs, coronary heart disease, atherosclerotic vascular disease, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides.

Subscribe to lipid-lowering drugs

lipid-lowering drugs

Management of Hypercholesterolemia

Treatment of High-Risk Older Adults with Lipid-Lowering Drug Therapy