Strategies for optimizing treatment outcomes

The relationship between increased levels of cholesterol and elevated risk for coronary heart disease (CHD) has been described in many epidemiological and well-designed prospective trials. Additionally, since first being elucidated by the Coronary Primary Prevention Trial, numerous trials have demonstrated that reducing blood cholesterol levels results in a corresponding reduction in risk for CHD. The evidence now indicates that cholesterol reduction confers up to a 35% reduction in total mortality, coronary mortality, coronary artery procedures, stroke, and other CHD-related events. This article reviews data that demonstrate that cholesterol reduction decreases CHD risk, discusses current and emerging treatment modalities, describes methods by which health care practitioners can enhance lipid treatment outcomes, and identifies educational tools that can be used to empower patients to improve their compliance and become actively involved in reducing their CHD risk.