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Therapy to reduce risk of coronary heart disease

Recent primary and secondary intervention studies have shown that reduction of low‐density lipoprotein cholesterol (LDL‐C) with statins significantly reduced coronary heart disease (CHD) morbidity and mortality. However, many patients with dyslipidemia who have or are at risk for CHD do not reach target LDL‐C goals. The recently updated National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines identify a group of patients at very high risk for CHD for more aggressive LDL‐C reduction and reaffirm the importance of high‐density lipoprotein cholesterol (HDL‐C) by raising the categorical threshold to 40 mg/dl. Lipid‐lowering therapy needs to be more aggressive in both primary and secondary prevention settings, and therapy should be considered to increase HDL‐C as well as lower LDL‐C in order to improve patient outcomes. Both combination therapy and the next generation of statins may provide improved efficacy across the dyslipidemia spectrum.