Use of combination therapy for dyslipidemia: a lipid clinic approach

Combination drug therapy has been used in the management of dyslipidemia by lipid clinics since the early 1980s. The explosion of statin use in the early and mid-1990s has caused a shift to monotherapy for dyslipidemia. However, the use of combination therapy has reemerged as a treatment option for patients who have elevated triglyceride and low-density lipoprotein (LDL) cholesterol levels as more attention is now focused on non-high-density lipoprotein cholesterol. This article discusses the use of combination therapy in a lipid clinic based on experiences from a multisite clinical practice of >48 physicians and 80,000 patients. Approaches to LDL lowering for complex dyslipidemias and management strategies for specific lipid-lowering therapies are provided.