Hypercholesterolaemia – how to achieve the treatment goals?
Hypercholesterolaemia, i.e. increased total and low-density-lipoprotein (LDL) cholesterol, is the main risk factor for coronary heart disease (CHD) and myocardial infarction (MI). Statins are the treatment of choice for hypercholesterolaemia. Large clinical trials have shown that lowering total and LDL cholesterol as much as possible is crucial for prevention of cardiovascular diseases. This is particularly important in secondary prevention, i.e. in patients with CHD, MI, transitory ischaemic attacks (TIA), stroke, atherosclerotic changes of carotid or periphery arteries and/or diabetes mellitus. However, a significant number of patients on lipid-lowering therapy still do not reach the treatment goals, partly because their physicians hesitate to increase the dose of statins due to fear of side effects. The solution could be co-administration of a statin with ezetimibe – a selective inhibitor of cholesterol absorption in the intestine. This approach may result in an incremental reduction of total and LDL cholesterol, which is more pronounced than the reduction achieved by a statin alone, and allow for reaching the treatment goals without increasing the risk of side effects
Key words:
cholesterol; cholesterol, LDL; coronary disease; ezetimibe; statins; myocardial infarction