[Which cholesterol-lowering drugs should be used in the primary prevention of cardiovascular disease?].

Background: Several clinical practice guidelines for the treatment of hypercholesterolaemia are available. The quality of these guidelines varies and the basis for their conclusions is often not clear. We have used systematic and explicit methods in developing a new set of recommendations. This is the last of three articles describing these guidelines.

Material And Methods: Evidence was found by a systematic search in databases and reference lists in guidelines and articles. A set of recommendations was prepared based on a critical appraisal of the literature. These were revised through discussions with a panel of physicians, and agreed upon after several iterations. The guidelines were circulated to professional, governmental and patient organisations.

Results And Interpretation: Statins should be first-choice drugs for the treatment of hypercholesterolaemia. Total cholesterol below 5 mmol/l and/or LDL cholesterol below 3 mmol/l are the recommended treatment goals for persons at high risk of coronary heart disease.