Approaches to the management of hypercholesterolaemia

SUMMARY Patients with hypercholesterolaemia need to be care- fully evaluated for underlying secondary or genetic causes. All such subjects require dietary advice. Those with total cholesterol levels persistently in excess of 6-5 mmol/l despite diet, and in the presence of multiple cardiac risk factors may need drug therapy. Drug ther- apy is likely to be life-long and the potential benefits need to be carefully assessed against the long-term safety of the agents employed. REFERENCES 1. Stamler J, Wentworth D, Neaton JD, for the MRFIT research group. (1986) Is relationship between serum cholesterol and risk of coronary heart disease continuous and graded? ]ournal of the American Medical Association, 2. Chen 2, Pet0 R, Collins et al. (1991) Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. British Medical Iournal, 303,276-282. 3. Frick MH, Elo 0, Haapa K, et al. (1987) Helsinki Heart Study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidaemia safety of treat- ment, changes