Guidelines for the management of hyperlipidemia: How can clinicians effectively implement them?

Guidelines support lowering cholesterol to decrease atherosclerotic cardiovascular disease (ASCVD) risk across the entire lifespan with intensive lifestyle intervention, as well as statin and non-statin pharmacotherapy for those at highest risk. Modest improvements in the initiation, use, and adherence to statin therapy in patients with ASCVD have occurred over the past decades. However, studies continue to document a less than desired implementation of guidelines highlighting a substantial and persistent treatment gap.

Statin and ezetimibe combination therapy in cardiovascular disease.

Purpose Of Review: To summarize the available data regarding the benefits of combination therapy with statins and ezetimibe in patients with cardiovascular disease.

Recent Findings: Extensive evidence, mostly in statin outcome trials, has shown that the magnitude of cardiovascular benefit is directly proportional to the degree of LDL cholesterol (LDL-C) reduction. As such, aggressive target goals for LDL-C levels have been established by guideline committees.

A review of lipid management in primary and secondary prevention.

Lipid management in primary and secondary prevention reduces cardiovascular morbidity and mortality. Lowering of low-density lipoprotein cholesterol (LDL-C) levels with statins remains the primary goal of therapy. For secondary prevention patients, those with coronary heart disease (CHD) or CHD risk equivalents, intensive LDL-C lowering is recommended, although the precise target value is still debated.

Atherosclerosis surrogate imaging trials come of age: for better or for worse?

Surrogate atherosclerosis imaging trials have been used to evaluate drugs for regulatory approval. These imaging trials have focused on two methodologies: carotid B-mode ultrasound to measure carotid intima-media thickness (CIMT) and coronary intravascular ultrasound (IVUS) to assess atheroma volume. Recent controversies exist regarding the clinical use of these imaging trials.