Cholesterol Guidelines for Adults (2001) (cont.)
Who should be considered for lipid-lowering medications?
1) Patients with CHD (prior heart attacks, strokes, bypass surgery, or angioplasty) or diabetes can greatly reduce their risk of future heart attacks or strokes by aggressively lowering LDL cholesterol. Thus, many patients are given LDL-lowering medications simultaneously with TLC to attain LDL cholesterol of below 100 mg/dl.
2) Patients who have been hospitalized for heart attack, angioplasty, or bypass surgery should be discharged on a LDL lowering medication in addition to TLC if the LDL cholesterol is >130 mg/dl. Some experts recommend LDL-lowering medications even if the LDL is 100-129 mg/dl.
3) Patients with no strokes, heart attacks, or other known CHD should also be considered for LDL-lowering medications if TLC is not successful in bringing LDL cholesterol down to target levels.
Statins are the most extensively studied and widely used LDL-lowering medications. Numerous large scale, long term trials have shown that statins and diet can reduce the risk of heart attacks and strokes in people with or without CHD. Other lipid-lowering agents include nicotinic acid, fibrates such as Lopid, and bile acid sequestrants such as Questran. Please refer to the Heart Attack Prevention forum on MedicineNet.com for an in-depth discussion of cholesterol management.
What is metabolic syndrome?
Evidence is accumulating that the CHD risk can be further reduced beyond LDL cholesterol-lowering by treating the various aspects of the metabolic syndrome.
How is metabolic syndrome treated?
Please refer to the Heart Attack Prevention forum of Medicinenet.com for further discussion on the treatment of high triglycerides and low HDL, as well as a review of the role of aspirin, B vitamins, and ACE inhibitors in the prevention of heart attack.
Medical Author: Dennis Lee, M.D.
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Last Editorial Review: 2/1/2005