[Which hypocholesteremic agents for which hypercholesterolemias?]

Three groups of drugs can be used in hypercholesterolemia: 1) Drugs chelating bile acids (resins) which stimulate LDL receptors. 2) HMG R inhibitors which competitively inhibit the enzyme and increase the synthesis of LDL receptors. 3) Fibrate derivatives which are second line drugs in pure hypercholesterolemia. They should be used in case of intolerance of resins and may be preferred to inhibitors in moderate forms for economic reasons of lower cost. However fibrates are the treatment of choice in hypertriglyceridemia and mixed hyperlipidemias. All fibrates increase HDL cholesterol. 4) Probucol, neomycin and nicotinic acid are adjuvant hypolipidemic agents. The following steps must precede the prescription of a hypolipidemic drug: 1) Classification of the disorder. 2) Elimination of secondary dyslipidemias. 3) Family assessment. 4) An absolutely essential dietary phase. 5) This is permanent treatment without gaps. 6) No other atherogenic risk factor should be allowed to persist. 7) Iatrogenic effects must be avoided.