Hyperlipidemia therapy: can it prevent coronary atherosclerosis?

Improvements in diagnosis permit primary care physicians to identify lipid disorders. Until recently, most of the therapy for coronary artery disease was directed at the symptoms produced by the ischemic myocardium. As more studies reveal the close relationship between the presence of abnormal lipid levels and the prevalence and progression of coronary artery disease, physicians who care for coronary patients should pay closer attention to the possibility of preventing or attenuating progression of the disease. The development of effective drugs represents an initial phase in long-range resolution of the problem of progressive vascular disease. While dietary management is important, pragmatic considerations suggest that modification of serum lipids to ideal levels will require the use of polypharmacy.