Diagnostics, Treatment and Economic Prescribing in Patients with Dyslipdemias
DOI: 10.3238/zfa.2010.0099PDF german translation / full article
Summary: Hypercholesterolemia is the most frequent dyslipidemia in Germany. Indication for treatment is based upon total cardiovascular risk (dependent on age, hypertension, HDL-cholesterol, nicotine use, diabetes mellitus, positive family history) and the expected benefit for affected patients.
Treatment primarily comprises diet and physical exercise. Complementary drug therapy might be added according to the individual patient risk. Its primary goal is to decrease cardiovascular risk rather than lowering elevated lipid values. Risk reduction is best documented for statins and among this group for simvastatin. A sensible and pragmatic approach appears to be the “fire-and-forget” strategy prescribing an evening dose of 20–40 mg simvastatin without further lipid controls or change of dosage.
Treatment indication in primary prevention depends on total cardiovascular risk. In secondary prevention, however, the indication is independent from any cholesterol values. Long-term treatment also should be offered to all patients with primary hypercholesterolemia.