Blum Manuel R, Stanga Zeno, Rodondi Nicolas
Universitätsklinik und Poliklinik für Allgemeine Innere Medizin, Inselspital, Bern.
Praxis (Bern 1994). 2013 May 8;102(10):585-9. doi: 10.1024/1661-8157/a001286.
Dyslipidemia is one of the main modifiable cardiovascular risk factors. There is strong evidence for the efficacy of lipid-lowering drugs in secondary prevention, as well as in primary prevention for patients at high cardiovascular risk. In primary prevention, indication for lipid-lowering interventions should be based on an individual assessment of the cardiovascular risk and on the LDL cholesterol level, despite less strong evidence for the efficacy of drug-based interventions in low risk patients. Treatment consists of statins, as well as lifestyle modifications such as body weight control and increased physical exercise. The latter constitute the primary intervention in patients at low cardiovascular risk. Secondary dyslipidemias due to an underlying medical condition and familial dyslipidemias such as Familial Hypercholesterolemia and Familial Combined Hyperlipidemia should be identified and treated accordingly, taking into account that the risk scoring systems are not appropriate in these situations.
血脂异常是主要的可改变心血管危险因素之一。有充分证据表明降脂药物在二级预防以及心血管高危患者的一级预防中有效。在一级预防中，降脂干预的指征应基于对心血管风险的个体评估以及低密度脂蛋白胆固醇水平，尽管在低风险患者中基于药物干预疗效的证据不太充分。治疗包括使用他汀类药物，以及进行生活方式改变，如控制体重和增加体育锻炼。后者是心血管低风险患者的主要干预措施。应识别并相应治疗由潜在疾病引起的继发性血脂异常以及家族性血脂异常，如家族性高胆固醇血症和家族性混合型高脂血症，同时要考虑到风险评分系统在这些情况下并不适用。
