A Review of the Rationale for Additional Therapeutic Interventions to Attain Lower LDL-C When Statin Therapy Is Not Enough

Statins alone are not always adequate therapy to achieve low-density lipoprotein (LDL) goals in many patients. Many options are available either alone or in combination with statins that makes it possible to reach recommended goals in a safe and tolerable fashion for most patients. Ezetimibe and bil...

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Bibliographic Details
Published in:Current atherosclerosis reports 2012-02, Vol.14 (1), p.33-40
Main Author: Shanes, Jeffrey G.
Format: Article
Language:English
Subjects:
Angiology
Anticholesteremic Agents - therapeutic use
Cardiology
Cardiovascular Diseases - blood
Cardiovascular Diseases - drug therapy
Cholesterol, LDL - blood
Drug Therapy, Combination
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Medicine
Medicine & Public Health
Practice Guidelines as Topic
Section Editor
Statin Drugs (M Clearfield
Statin Drugs (M Clearfield, Section Editor)
Treatment Outcome
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Summary:Statins alone are not always adequate therapy to achieve low-density lipoprotein (LDL) goals in many patients. Many options are available either alone or in combination with statins that makes it possible to reach recommended goals in a safe and tolerable fashion for most patients. Ezetimibe and bile acid sequestrants reduce cholesterol transport to the liver and can be used in combination. Niacin is very effective at lowering LDL, beyond its ability to raise high-density lipoprotein and shift LDL particle size to a less atherogenic type. When statins cannot be tolerated at all, red yeast rice can be used if proper formulations of the product are obtained. Nutrients can also be added to the diet, including plant stanols and sterols, soy protein, almonds, and fiber, either individually or all together as a portfolio diet. A clear understanding of how each of these strategies works is essential for effective results.
ISSN:1523-3804
1534-6242
DOI:10.1007/s11883-011-0222-z