Achieving cholesterol goals. Current and future drug therapies.

Low-density lipoprotein cholesterol (LDL-C), the prime target of antilipidemic therapy, should be lowered to below 100 mg/dL for patients with coronary heart disease (CHD) and CHD risk equivalents, including diabetes, noncoronary atherosclerotic disorders, and multiple risk factors and a 10-year CHD risk greater than 20%. Five 3-hydroxy-3- methylglutaryl-CoenzymeA reductase inhibitors ("statins") are approved for use in the United States. A sixth, rosuvastatin, is awaiting approval. Of all the statins, rosuvastatin provides the greatest reductions in LDL-C along with the greatest increases in high-density lipoprotein cholesterol. The statins can be used alone, or in combination with a bile acid sequestrant, ezetimibe, or niacin in patients with mixed dyslipidemias.