[Update dyslipidemia]

Abstract

The treatment of dyslipidemia is a cornerstone of atherosclerosis prevention. Statin-based reduction of LDL cholesterol plays a central role in this context. Whether and to what extent other lipids such as triglycerides, HDL-cholesterol, lipoprotein(a) should also be addressed is still under discussion. However, in the treatment of hypertriglyceridemia and combined hyperlipoproteinemia, life-style modification plays a significant role. Important issues are correct classification of the dyslipidemia, a LDL-cholesterol target based on the absolute risk of the patient, and a therapeutic strategy that also includes treatment of other risk factors. If statin therapy not sufficient to reach the treatment target, combination therapy with ezetimibe, bile acid binding substances, fibrates or ω-3 fatty acids should be discussed, considering the lipid profile, the overall risk, and potential side effects. Patients with severe LDL hypercholesterolemia or greatly elevated lipoprotein(a) levels should be considered for regular lipid apheresis if the cardiovascular disease is progressing.