Management of patients’ lipid levels is a key daily activity for all GPs. While statins are the most often used lipid lowering agents, each patient’s lipid profile should be examined as a nonstatin choice may be more appropriate.
- Lipid and lipoprotein levels are key risk factors in coronary heart disease (CHD) and ischaemic stroke.
- Presciption of lipid therapy is likely to remain or even increase as a key daily activity for GPs.
- The predominant lipid pattern in an individual patient is a factor in selecting the most appropriate lipid therapy choice.
- LDL cholesterol reduction by statins reduces the future risk of cardiovascular disease in patients with and without a prior history of CHD.
- There remains significant residual coronary risk in patients despite statin therapy.
- Those patients not reaching target LDL cholesterol levels on statin therapy may be better managed by the addition of ezetimibe to the statin therapy, or a switch to the combined ezetimibe–simvastatin preparation.
- Patients with low HDL cholesterol and high triglyceride levels may be better managed with fenofibrate or a combination of statin and fenofibrate.
- As a general rule, combination lipid therapy is a second step treatment rather than an initiating therapy.