oa SA Pharmaceutical Journal - The differences in treatment of hypertriglyceridaemia vs. hypercholesterolaemia : review



Treatment of hyperlipidaemia needs to be tailored to each individual patient, taking into consideration the risk factors for cardiovascular disease, lipid profile, response to treatment and adverse effects of the drugs. Low-risk patients may benefit from lifestyle modifications only, while patients at high risk of contracting cardiovascular disease may need immediate pharmacological treatment, despite only moderate abnormalities in lipid profiles. Since hypertriglyceridaemia is often accompanied by low levels of high-density lipoprotein (HDL) cholesterol, fibrates may be considered as first-line treatment. Fibrates reduce triglyceride levels and also increase HDL levels. Statins are first choice in treating hypercholesterolaemia as they have been shown to reduce mortality, in addition to lowering low-density lipoprotein (LDL) cholesterol levels. Severe or mixed hyperlipidaemias may require combination therapy. Since the combination of statins with fibrates can lead to myotoxicity or rhabdomyolysis, drugs that lower the risk for these side-effects should be used. Fenofibrate, in combination with pravastatin or fluvastatin, may be considered.


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