Controversies in primary prevention among hyperlipidemic patients

Data from a number of population-based primary prevention trials clearly indicate that reducing total serum cholesterol levels leads to a reduced risk of coronary artery disease and death. Similarly, for patients with coronary artery disease, reducing total serum cholesterol levels proved to be an effective secondary prevention strategy, leading to a reduced risk of coronary events and death. Targeting high risk patients is a particularly important component of primary prevention. The overall benefit of treatment is significantly reduced when cholesterol-lowering strategies are initiated later in life. To assist in both primary and secondary prevention strategies, an outline of guidelines developed by a Health Canada working group for the management of hyperlipidemia have recently been published.