Therapy for Hyperlipidemia

Med Clin North Am. 2024 Sep;108(5):881-894. doi: 10.1016/j.mcna.2024.03.005. Epub 2024 Jun 4.

Abstract

Significant advances in atherosclerotic cardiovascular (ASCVD) risk stratification and treatment have occurred over the past 10 years. While the lipid panel continues to be the basis of risk estimation, imaging for coronary artery calcium is now widely used in estimating risk at the individual level. Statins remain first-line agents for ASCVD risk reduction but in high-risk patients, ezetimibe, proprotein convertase subtilisin kexin-9 inhibitors, and bempedoic acid can be added to further reduce individual cardiovascular risk based on results of cardiovascular outcomes trials. Results of randomized control trials do not support use of medications targeted at triglyceride lowering for ASCVD risk reduction, but icosapent ethyl can be considered.

Keywords: ASCVD; Bempedoic acid; Coronary artery calcium; Ezetimibe; Hypertriglyceridemia; Lipoprotein (a); PCSK9 inhibitors; Statins.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents / therapeutic use
  • Ezetimibe / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Hyperlipidemias* / drug therapy
  • Hypolipidemic Agents / therapeutic use
  • PCSK9 Inhibitors

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents
  • Ezetimibe
  • Anticholesteremic Agents
  • PCSK9 Inhibitors