Management of atherogenic hyperlipidaemia.

After defining the type of hyperlipoproteinaemia (the three main are IIa, I lb and IV), confirming its primary nature (ie. after eliminating the variou s causes of secondary hyperlipoproteinaemia) and after defining the therape utic objective (different according to the context of primary or secondary cardiovascular prevention), treatment must be prescribed. It always consist s of diet, and very often a lipid-lowering drug. The remarkable results obt ained with statins in studies of primary prevention, secondary prevention a nd regression of atherosclerosis does not mean that they can be prescribed blindly. Therapeutic indications depend on the type of hyperlipidaemia. By limiting the discussion to the three main types of atherogenic hyperlipopro teinaemia, treatment consists of: in pure type IIa hypercholesterolaemia: a first-line statin (or fibrate or resin in the case of adverse effects); in pure type IV hypertriglyceridaemia: a fibrate and possibly omega-3 fatty a cids; in combined or mixed type Ilb hyperlipidaemia: a statin in the case o f type Ilb with predominant hypercholesterolaemia, a fibrate in the case of type Ilb with predominant hypertriglyceridaemia, failure to comply with th ese rules can lead to poor laboratory results.