ABSTRACT
Hypercholesterolaemia is a condition in which total and low-density lipoproteins (LDL)-cholesterol levels are increased but the levels of triglycerides are normal. Fibrates are mainly used for mixed hyperlipidaemia, and can be added to a statin under specialist advice. The impact of the lipid abnormalities is influenced by other cardiovascular risk factors, such as age, cigarette smoking, diabetes, hypertension and a positive family history of coronary heart disease and stroke. Accelerated development of atherosclerosis is strongly associated with increased concentrations of LDL cholesterol and reduced concentrations of high-density lipoprotein cholesterol. Available lipid-lowering drugs include statins, fibrates, fish oils and drugs to reduce cholesterol absorption. The benefits of statin therapy in large populations greatly outweigh their adverse effects. The two main adverse effects - liver damage and rhabdo-myolysis - are very rare with currently available statins. Patients who have a 20% risk or higher should normally receive a statin.
