Cholesterol lowering has been shown to be of benefit in reducing the risk of coronary heart disease (CHD) in both patients with established CHD (secondary prevention) and those without (primary prevention). In secondary prevention trials, moderate cholesterol lowering reduced the rate of new events and decreased both morbidity and mortality from cardiovascular disease. In primary prevention, a reduction of cholesterol by 20% has produced a 31% reduction in recurrent coronary morbidity, a 33% reduction in coronary mortality, and 22% less total mortality. The target of therapy is low-density lipoprotein (LDL) cholesterolin patients with established CHD, goal LDL is < or = 100 mg/dL. In high-risk patients without established CHD, the target goal for LDL cholesterol is < or = 130 mg/dL. Nondrug measures, bile acid sequestrants, nicotinic acid, and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors all play important roles in cholesterol-lowering therapy.

译文

降低胆固醇已被证明可以降低冠心病 (二级预防) 和无冠心病 (一级预防) 的患者的冠心病 (CHD) 风险。在二级预防试验中,适度降低胆固醇降低了新事件的发生率,并降低了心血管疾病的发病率和死亡率。在一级预防中,通过20% 降低胆固醇已经31% 降低了复发性冠状动脉发病率,33% 降低了冠状动脉死亡率,22% 降低了总死亡率。治疗的目标是建立CHD的低密度脂蛋白 (LDL) 胆固醇患者,目标LDL <或 = 100 mg/dL。在没有建立冠心病的高危患者中,LDL胆固醇的目标目标是 <或 = 130 mg/dL。非药物措施,胆汁酸螯合剂,烟酸和3-羟基-3-甲基戊二酰辅酶a (HMG-CoA) 还原酶抑制剂均在降低胆固醇的治疗中起重要作用。

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