Should Hyperlipoproteinemia Be Treated In Patients With Coronary Artery Disease?

Abstract

THE RELATIONSHIP between serum lipid levels and the occurrence of coronary atherosclerosis has been adequately analyzed to confirm that elevated serum cholesterol levels and, almost certainly, elevated serum triglyceride levels are among the major risk factors associated with the development of coronary artery disease and myocardial infarction. This concept has been aided by a rational classification of lipid abnormalities based on the characterization of serum lipoproteins. The classification has been most beneficial as a guide to development of logical dietary and pharmacologic regimens for lowering serum lipid concentrations as well as better definitions of both the inheritance and metabolic factors associated with the abnormalities. Type IIa, IIb, and IV hyperlipoproteinemia, all reflecting elevated serum cholesterol or triglyceride levels or both, are associated with the risk of premature atherosclerosis and myocardial infarction. Suitable dietary and drug regimens are available for the control of hyperlipoproteinemia. The temptation to treat an abnormality, in