Management of hypercholesterolemia. A primary care perspective.

We now have sufficient evidence to recommend an aggressive program of the detection and treatment of hypercholesterolemia. All adult patients should be screened and evaluated, and treatment decisions should be based on their LDL-cholesterol levels and the presence or absence of other risk factors. Diet therapy should be initiated in motivated patients for three to six months progressing from a qualitative to a quantitative approach. Patients with persistent elevations in their LDL-cholesterol levels who accept drug therapy can be begun on a regimen of nicotinic acid, gemfibrizol or bile acid-binding resins, and, when necessary, lovastatin.