[Diets and drugs to lower blood cholesterol]

The scope of this paper is deliberately restricted to diets and drugs devised to lower blood cholesterol levels in pure hypercholesterolaemia (ex-type II in the international classification). This treatment is twofold: (1) Diets. In all cases except cardiovascular emergencies treatment should begin with a diet. If the subject is overweight, an overall low-calorie diet should be prescribed first. This will be followed by a diet with a low cholesterol and saturated fats content and a high polyunsaturated fats content, the latter including linoleic acid (C18:12) present in sunflower margarine and sunflower, maze and soya oils or eicosapentaenoic acid (C20:5) and docosahexaenoic acid (C22:6) present in fatty fish. (2) Cholesterol-lowering drugs should then be prescribed if necessary. The most effective of these drugs are cholestyramine and fibrate derivatives. HMG CoA reductase inhibitors will shortly be available in France. This daily medicinal treatment should of course be uninterrupted, but it may be "reduced" in case of excellent therapeutic response.