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Treatment of lipids (including hypercholesterolemia) in secondary prevention

Author
Robert S Rosenson, MD
Section Editor
Mason W Freeman, MD
Deputy Editor
Gordon M Saperia, MD, FACC

INTRODUCTION

Patients with known cardiovascular disease (CVD) are at high risk for cardiovascular (CV) events. Treatment in such patients, as well as in other patients known to have a similar risk of CV events, is discussed as secondary prevention. In secondary prevention, statins have been shown to reduce CV events and all-cause mortality. Trials of some other lipid-lowering agents (niacin, cholestyramine, gemfibrozil) have also shown reductions in CV events in patients not treated with statins.

The major issues related to the treatment of different causes of hypercholesterolemia for secondary prevention of CVD are reviewed here, as are the medications available for treatment.

The clinical trials upon which the recommendations are based are discussed in detail separately, as is treatment in primary prevention. (See "Clinical trials of cholesterol lowering in patients with cardiovascular disease or diabetes" and "Treatment of lipids (including hypercholesterolemia) in primary prevention".)

Also discussed separately is a discussion of the appropriate intensity of lipid lowering therapy in secondary prevention. (See "Intensity of lipid lowering therapy in secondary prevention of cardiovascular disease".)

IDENTIFICATION OF PATIENTS AT RISK

We suggest that all patients with known cardiovascular (CV) disease or at similar risk be treated with statin therapy when tolerated. (See 'Summary and recommendations' below.)

                                

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Literature review current through: Nov 2016. | This topic last updated: Mon Apr 04 00:00:00 GMT+00:00 2016.
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