Managing dyslipidaemia ? multiple patients and multiple approaches: metabolic syndrome, familial hypercholesterolaemia and hypertension

Abstract

High risk of coronary heart disease (CHD) events is present in a number of patient populations in addition to those with pre-existing CHD, other atherosclerotic disease or diabetes. Patients with the metabolic syndrome are at increased CHD risk and require attention to low-density lipoprotein cholesterol (LDL-C) lowering in addition to management of hypertriglyceridaemia, low high-density lipoprotein cholesterol and non-lipid risk factors. Patients with hypertension in addition to other cardiovascular risk factors are at increased risk of CHD and have recently been shown to derive marked benefit from statin treatment. Patients with heterozygous familial hypercholesterolaemia, characterised by dramatically raised LDL-C and high risk for early CHD, require large reductions in LDL-C to meet recommended target levels, and newer statins possess the LDL-C-lowering efficacy to bring many of these patients to such goals. Identification of high-risk patients and prompt institution of appropriate management strategies can serve to reduce the overall burden of cardiovascular disease.