The changing face of dyslipidemia therapies

摘要

To date, the major emphasis of dyslipidemia management has focused on the reduction of serum low-density lipoprotein cholesterol (LDL-C) levels, which several robust trials show significantly decreases the risk of coronary heart disease (CHD). To achieve goal LDL-C levels will require that some individuals take more than 1 cholesterol-lowering medication. In addition, many dyslipidemic patients also have concomitant risk factors for cardiovascular disease including hypertension, elevated plasma glucose, and high body mass index, requiring additional therapies. In addition to drugs that lower LDL-C, several agents under investigation are targeting other markers for decreasing the risk of atherosclerotic disease. Some of these agents target the reduction of C-reactive protein with a more potent statin, increased high-density lipoprotein cholesterol (HDL-C) with the cholesterol ester transfer protein inhibitor, inhibition of triglyceride or very-low-density lipoprotein cholesterol (VLDL-C) with the acyl coenzyme A: cholesterol acyltransferase inhibitor, reduction of VLDL-C with microsomal triglyceride transfer protein inhibitor, change in percentage coronary atheroma volume with HDL-C mimetics, and the reduction of bile acid transport and reabsorption with the ileal bile acid transport inhibitors. This review will provide an overview of the existing landscape for the medical treatment of dyslipidemia, including available therapies and future trends. 2006 Sage Publications.