Current approaches to drug therapy for the hypercholesterolemic patient.

CAD is a complex disease with multiple etiologies and aggravating events. Yet, elevated plasma cholesterol levels, chiefly in the form of LDL, are essential for the progression of the atherosclerotic lesion. Any total plasma cholesterol level above an ideal of 180 mg/dl (and an LDL cholesterol level of 100 mg/dl) must be considered atherogenic in the presence of other risk factors. In patients at high risk for death from CAD, combined diet and drug therapy should have as a goal the attainment of ideal lipoprotein values. Drug therapies are now available that make it possible to substantially lower elevated LDL levels in almost all patients and even to achieve ideal levels in those at highest risk.