The past, present and future of lipidlowering therapy

摘要

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. Dyslipidemia is a major risk factor, with elevated plasma lipids having a well-established relationship with CVD. While lifestyle modification and statins have played an important role in reducing risk, many patients develop CVD despite best care. Statins remain the most prescribed lipid-lowering therapy, yet many patients may require additional therapies. Fibrates, ezetimibe and bile acid sequestrants have been extensively investigated thus far, with mixed results. Newer classes of lipid modifying therapy include monoclonal antibodies to PCSK9, lomitapide and cholesterol ester transfer protein inhibitors. In this review, we revisit the history of lipid-lowering therapy, the pharmacotherapies currently used and future direction of research.