Maintaining Cardiovascular Health in Patients With Mixed Dyslipidemia: Optimizing the Management of Hypertriglyceridemia and Non-HDL Cholesterol

OBJECTIVE: To review the role of elevated levels of serum cholesterol and triglycerides in coronary heart disease (CHD) and the increasing recognition of the need to improve the overall lipid profile of patients with mixed dyslipidemia to further mitigate CHD risk. SUMMARY: Hypercholesterolemia, represented by elevated levels of low-density lipoprotein cholesterol (LDL-C), is a well-known and studied dyslipidemia associated with increased risk for CHD. Statin treatment is highly effective for lowering serum levels of LDL-C. Nevertheless, mixed dyslipidemia associated with low levels of high-density lipoprotein cholesterol (HDL-C) and/or elevated triglycerides, which are risk factors independent of high LDL-C levels, are common. Although interventions using statins are the standard-of-care in mixed dyslipidemia, statin treatment alone does not adequately address these components of the lipid profile in many patients, resulting in residual dyslipidemia and considerable CHD risk. Fibrates, niacin, and omega-3 fatty acids are efficacious additional potential treatment options for patients with mixed dyslipidemia.