[Management of atherogenic hyperlipidemia].

After defining the type of hyperlipoproteinaemia (the three main are IIa, IIb and IV), confirming its primary nature (i.e. after eliminating the various causes of secondary hyperlipoproteinaemia) and after defining the therapeutic objective (different according to the context of primary or secondary cardiovascular prevention), treatment must be prescribed. It always consists of diet, and very often a lipid-lowering drug. The remarkable results obtained with statins in studies of primary prevention, secondary prevention and regression of atherosclerosis does not mean that they can be prescribed blindly. Therapeutic indications depend on the type of hyperlipidaemia. By limiting the discussion to the three main types of atherogenic hyperlipoproteinaemia, treatment consists of: in pure type IIa hypercholesterolaemia: a first-line statin (or fibrate or resin in the case of adverse effects); in pure type IV hypertriglyceridaemia: a fibrate and possibly omega-3 fatty acids; in combined or mixed type IIb hyperlipidaemia: a statin in the case of type IIb with predominant hypercholesterolaemia, a fibrate in the case of type IIb with predominant hypertriglyce-ridaemia, failure to comply with these rules can lead to poor laboratory results.