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Hyperlipidemia. What to do when life-style changes aren't enough.

Most lipid abnormalities seen in a primary care practice can be grouped into three categories: hypercholesterolemia, combined hyperlipidemia, and hypertriglyceridemia. Three to 6 months of dietary and life-style alterations should be tried before drug treatment is initiated. Drugs for each category should be chosen on the basis of clinical efficacy, established long-term safety, and effects on low-density and high-density lipoprotein cholesterol and triglyceride levels. To maximize compliance, physicians should advise patients on dosing schedules, side effects, and required monitoring. Combination drug therapy is often necessary to reach treatment goals, especially in patients with genetic hyperlipidemia and/or symptomatic coronary artery disease.