高血脂治療

Hyperlipidemia



For most patients with CVD, independent of baseline low density lipoprotein cholesterol (LDL-C), we recommend lifelong high-intensity statin therapy (atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg) rather than moderate intensity statin or no LDL-C lowering therapy (Grade 1A). For patients who do not tolerate these doses, the maximally tolerated dose of a statin should be used.

In patients at very high risk (see 'Definitions' above) for CVD events and whose LDL-C remains above 70 mg/dL, we recommend the addition of ezetimibe or a PCSK9 antibody (Grade 1B). In most cases this second drug will be ezetimibe for cost reasons.

In patients at high risk (see 'Definitions' above) for CVD events and whose LDL-C remains above 70 mg/dL after treatment with statin, we suggest the addition of ezetimibe or a PCSK9 antibody (Grade 2B).

Elevated triglyceride levels are independently associated with cardiovascular risk, particularly coronary heart disease risk and the results of Mendelian Randomization studies make causality likely.