[Current strategies in the diagnosis and therapy of hyperlipoproteinemias]

The determination of total cholesterol (and eventually triglycerides) is sufficient for screening purposes. Values below 5.2 mmol/l (200 mg/dl) may be considered ideal, where as higher values need a differentiated diagnostic evaluation which should include the measurement of triglycerides and of HDL-cholesterol after 12 h fasting. The decision for a drug therapy should consider other risk factors such as hypertension, smoking, diabetes mellitus, male sex, positive family anamnesis for myocardial infarction already existing and coronary heart disease. The treatment of a dyslipoproteinemia should always start with dietary measures. If these are not successful, a lipid-regulating drug therapy should be started in addition to the diet. The choice of the drug depends on the type of dyslipoproteinemia and its genetic and metabolic cause and on the individual side effects.