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(Chest. 2001;120:979-988.)
© 2001 American College of Chest Physicians

Lipid Disorders*

Justification of Methods and Goals of Treatment

Joel B. Braunstein, MD; Alan Cheng, MD; Gregory Cohn, MD; Monica Aggarwal, MD; Caitlin M. Nass, NP and Roger S. Blumenthal, MD, FCCP

* From the Ciccarone Center for the Prevention of Heart Disease (Drs. Braunstein, Cheng, Blumenthal, and Ms. Nass), Division of Cardiology, Department of Internal Medicine, The Johns Hopkins Hospital, Baltimore, MD; the Department of Internal Medicine (Dr. Cohn), Cleveland Clinic Florida, Ft. Lauderdale, FL; and the Department of Internal Medicine (Dr. Aggarwal), New England Medical Center, Boston, MA.

Correspondence to: Roger S. Blumenthal, MD, FCCP, Director of Preventive Cardiology, Johns Hopkins Hospital, 600 N. Wolfe St, Carnegie 538, Baltimore, MD 21287; e-mail: rblument{at}jhmi.edu

Dyslipidemia is a major risk factor for coronary heart disease (CHD). While some uncertainty exists about the clinical significance of improving high-density lipoprotein cholesterol and triglyceride levels, large primary- and secondary-prevention studies aimed at lowering low-density lipoprotein cholesterol levels with statins have convincingly reduced CHD events and total mortality. Despite the strong clinical evidence and widely publicized treatment guidelines, many hyperlipidemic patients receive inadequate lipid-lowering treatment. This failure to achieve clinical treatment goals may be due to poor physician adherence to treatment guidelines, patient noncompliance, and the presence of concomitant medical conditions that modify typical hyperlipidemia management. This review considers the challenges and available strategies to optimize lipid management in patients at risk for CHD.

Key Words: cardiovascular risk factors • coronary heart disease • dyslipidemia • hypercholesterolemia • lipid-lowering agents • statins




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