Treating mixed dyslipidemias: Why and how

Patients with only mildly elevated low‐density lipoprotein cholesterol values but low high‐density lipoprotein cholesterol (HDL‐C) and/or high triglyceride levels are at high risk for cardiovascular disease. 3‐Hydroxy‐3‐methylglutaryl‐coenzyme A reductase inhibitors (also known as statins) have been shown to slow coronary heart disease (CHD) progression, reduce CHD events in patients with low HDL‐C levels, and raise HDL‐C concentrations in patients with mixed dyslipidemias. Some, but not all trials of fibrates have shown benefit in patients with low HDL‐C levels. Combination therapy with a statin plus either a fibrate or niacin is effective in improving the entire lipid profile, but may increase cost and side effects.