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[Drug treatment of hyperlipidemia]
1Ospedale Beata Vergine, Mendrisio.
Insights
New Swiss cardiology guidelines recommend dietary treatment for high cholesterol (hyperlipaemias) and abnormal cholesterol/HDL ratios. Drug therapy is considered if diet fails, especially for patients with coronary heart disease or other risk factors.
Area of Science:
- Cardiology
- Lipid Metabolism
Background:
- Hyperlipaemias pose significant cardiovascular risks.
- Existing guidelines for hyperlipaemia management require updates.
Purpose of the Study:
- To present the 1989 directives from the Swiss Foundation for Cardiology for treating hyperlipaemias.
- To outline criteria for initiating dietary and pharmacological interventions.
Main Methods:
- Review of current understanding and clinical practice regarding hyperlipaemia treatment.
- Establishment of specific cholesterol and cholesterol/HDL ratio thresholds for intervention.
- Definition of patient subgroups and risk factors necessitating drug therapy.
Main Results:
- Dietary treatment is recommended for cholesterol > 6.5 mmol/l or cholesterol/HDL ratio > 5.
- In cases of coronary heart disease, cholesterol > 5.2 mmol/l warrants dietary intervention.
- Drug treatment is considered if dietary changes are ineffective after 3-6 months, particularly in high-risk individuals.
Conclusions:
- The guidelines provide a structured approach to managing hyperlipaemias.
- Pharmacological intervention should be considered for persistent hyperlipaemia, especially in the presence of cardiovascular risk factors.
- Combined therapies may be necessary for refractory cases or high-risk patients.
Abstract:
The working panel of the Swiss Foundation for Cardiology has elaborated in 1989 new directives for the treatment of hyperlipaemias. Cholesterol values over 6.5 mmol/l with a cholesterol/HDL ratio over 5 and, in case of coronary heart disease, cholesterol values over 5.2 mmol/l should first be treated by diet. If after 3-6 months, in spite of dietary treatment, cholesterol values remain superior to 6.5 mmol/l or the cholesterol/HDL ratio superior to 6.5, drug treatment must be considered in case of coronary heart disease or arteriosclerosis, considerably abnormal lipid values (cholesterol greater than 7.8 mmol/l; in case of coronary heart disease: cholesterol greater than 6.5 mmol/l), other risk factors, positive family history for coronary heart disease and younger men. Most of the medicaments available today reduce total cholesterol by 10-30%. Combined therapies can be indicated, if in the presence of high risks the different possibilities of monotherapy have not led to the desired success.