GOALS AND PROCEDURE OF LIPID INTERVENTION IN CORONARY HEART-DISEASE

In all patients with coronary heart disease a fasting lipid profile (t otal cholesterol, LDL cholesterol, HDL cholesterol, triglycerides) sho uld be obtained. Hyperlipidemias can then be classified as hypercholes terolemia (LDL cholesterol elevated), mixed hyperlipidemia (LDL choles terol elevated, triglycerides elevated) and hypertriglyceridemia (trig lycerides elevated). Primary goal of lipid intervention is a LDL chole sterol < 100 mg/dl, secondary goals are HDL cholesterol > 35 mg/dl and triglycerides < 200 mg/dl. These goals can be reached by dietary inte rvention alone (reduction in fat and modification of fat intake) or in combination with lipid lowering drugs. Monotherapy with HMG-CoA reduc tase inhibitors or combined therapy with bile acid sequestrants will a llow a reduction in LDL cholesterol by more than 50%, in predominant h ypertriglyceridemia fibrates or nicotinic acid will lower triglyceride s and elevate HDL cholesterol.