Rationale for Effective Treatment of Hypercholesterolemia

The primary objective of treating hypercholesterolemia is to reduce the patientʹs risk of developing coronary artery disease (CAD). Reducing low-density lipoprotein (LDL) cholesterol levels to achieve National Cholesterol Education Program (NCEP) goal lipid levels greatly reduces this risk. Treatment of additional risk factors for CAD (high blood pressure, diabetes, smoking) should be addressed and modified as part of appropriate patient management, but a high LDL cholesterol level is a major risk factor. Therefore, to effectively modify morbidity and mortality, reaching and maintaining NCEP target lipid levels should be the goal of lipid-lowering therapy. Epidemiologic data indicate that most adults in the United States need <30% reduction in LDL cholesterol level to achieve their NCEP goal. Regardless of the intervention or therapeutic agent used, the results of numerous studies have demonstrated that reducing LDL cholesterol levels to NCEP goals will result in significant reduction of CAD risk. (Am J Cardiol 1996;78(suppl 6A):4–12)