Management of hyperlipidemias: an update.

The discovery of the key enzymes, receptors, and transporters in cholesterol biosynthesis has enabled us to assemble fragments of knowledge concerning lipids and lipoproteins into dynamic pathways, leading to the development of a multitude of lipid-lowering drugs. After a brief recapitulation of the pathways of cholesterol metabolism and the dermatologic manifestations of lipid derangement, we shall review drugs which modify intestinal cholesterol and bile-acid reabsorption, and hepatic lipoprotein biosynthesis and catabolism. The current literature is examined to determine future therapeutic targets in lipid metabolism, as well as the role of traditional foods as lipid-lowering agents. The latest National Cholesterol Education Program guidelines for managing hypercholesterolemia are also discussed.