Achievement of low-density lipoprotein cholesterol goals: new strategies to address new guidelines

A significant gap exists between established therapy for patients with hypercholesterolemia and clinical practice. At-risk patients are often not treated, and many who are being treated do not attain optimal lipid levels.Numerous studies in the literature indicate that target low-density lipoprotein cholesterol (LDL-C) in patients with coronary heart disease should be less than 100 mg/dL (2.6 mmol/L). The various agents used to treat hyperlipidemia may affect different steps of cholesterol and lipoprotein metabolism. When monotherapy with these agents is insufficient to achieve therapeutic goals, co-administration of two agents with complementary mechanisms of action may be indicated. A new class of compounds, the selective cholesterol absorption inhibitors such as ezetimibe, complement available pharmacologic agents and may provide clinicians with an excellent option for helping patients achieve optimal LDL-C levels.