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Are add-on agents to statin therapy necessary in hypercholesterolemia?

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Pages 695-707 | Published online: 18 Jan 2017
 

Abstract

Elevated cholesterol is a major risk factor for atherosclerosis and coronary heart disease, and its control remains poor. Diet and exercise may not achieve LDL-C goals, particularly in high-risk patients. Statins are first-line treatment for lowering LDL-C. Recent ACC/AHA guidelines focus on groups benefiting the most from a statin, as well as using higher dose statins rather than a low-dose statin in combination with other cholesterol-lowering agents. Statin monotherapy will be inadequate to get half of treated patients to LDL-C goal, necessitating add-on therapy. Combining a statin with a bile acid sequestrant, fibrate or ezetimibe can help achieve lipid goals, and a bile acid sequestrant has the unique ability to reduce LDL-C, while improving glycemic control in patients with diabetes.

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