J Clin Outcomes Manage
An evidence-based approach to the use of combination drug therapy for mixed dyslipidemia
Harper CR, Jacobson TA
Educational Needs Addressed Dyslipidemia is one of the major modifiable risk factors for coronary heart disease (CHD), the leading cause of death among U.S. men and women. Most patients with CHD have multiple lipid abnormalities. The condition known as mixed dyslipidemia (ie, elevated LDL cholesterol and triglyceride levels combined with decreased levels of HDL cholesterol) is commonly seen in patients with diabetes and metabolic syndrome. In 2001, the Adult Treatment Panel III of the National Cholesterol Education Program established LDL and non-HDL goals for patients with mixed dyslipidemia. Recently, more aggressive goals for high-risk patients were established. Treatment for these patients may require therapy with 2 or 3 lipid-lowering drugs, yet some clinicians have been reluctant to utilize combination therapy because of safety concerns. This article reviews the available evidence for treatment of mixed dyslipidemia. Educational Objectives After participating in this CME activity, primary care physicians should be able to 1. Know the new NCEP/ATP III target goals for LDL cholesterol and non-HDL cholesterol 2. Determine the optimal drug treatment strategies for lowering LDL cholesterol and non-HDL cholesterol in patients with mixed dyslipidemia 3. Be familiar with the safety issues associated with lipid-lowering monotherapy and combination drug therapy 4. Describe recent clinical trials with lipid-lowering therapy that support the evidence for treating patients with mixed dyslipidemia
Case-Based Review, CME
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