CARING FOR PATIENTS WITH DYSLIPIDEMIA

There is now an enormous amount of literature on the relationship betw een blood lipids and coronary artery disease. It is clear that the tre atment by modification of the diet and hypolipidaemic drugs is associa ted with a decrease of the coronary events. However there is no cure f or any of the primary dyslipidaemias and relative treatment involves a life-long commitment by the patient. In addition the efficiency of th e treatment is dramatically different in patients at very high risk (s econdary prevention, combination of several risk factors) and in those at moderate risk Furthermore, patient's compliance is usually low. Th erefore management of the hyperlipidaemic patients requires a rigorous approach to evaluate the global risk and consequently to adapt the tr eatment at an individual level. We describe here our out-patient clini c in which about 6000 hyperlipidaemic patients have been referred. We indicate the strategy that we used for taking care the patients includ ing 1) the education of the subjects 2) the detection of secondary hyp erlipidaemia 3) the evaluation of the global risk including non-invasi ve evaluation of the atherosclerosis and the results of such approach (for example, we found a much higher percentage of positive exercise E CG in patients with carotid atherosclerosis in our ultrasonographic ex aminations).