Vol 34, (6):402-512
Management of hyperlipidaemia
Nigel Stocks, BSc, MBBS, MD, DipPH, FRACGP, FAFPHM, is Senior Lecturer, and Deputy Head, Department of General Practice, University of Adelaide, South Australia.
James Allan, MBBS, is a general practitioner, and PHCRED Research Fellow, Department of General Practice, University of Adelaide, South Australia.
Peter R Mansfield, BMBS, is a general practitioner, Willunga, Research Fellow, Department of General Practice, University of Adelaide, South Australia, and Director, Healthy Skepticism Inc.
BACKGROUND Hyperlipidaemia is a general term for elevated concentrations of any or all lipids in the plasma. An elevated cholesterol is one of several risk factors for coronary heart disease (CHD). In Australia, the use of cholesterol lowering drugs, mainly statins, consumes over $880 million or 16% of the Pharmaceutical Benefits Scheme drug budget and is growing.
OBJECTIVE This article focusses on primary hypercholesterolaemia, its relationship with CHD, and its management in the community setting.
DISCUSSION There is strong evidence that treating middle aged men with statins who have established CHD will reduce overall mortality, CHD morbidity, or mortality and stroke. There is weaker but reasonable evidence for treating men aged over 65 years and women of any age who have CHD, or people without CHD but at high risk. There may be some benefits for patients with stroke and peripheral vascular disease who are at risk of CHD. While discontinuation rates are high, the occurrence of serious adverse reactions are infrequent.
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