Lipid metabolism problems are a regular occurrence. They play a crucial role in the development of atherosclerosis and can be efficiently addressed with lifestyle changes and medications. A selected search yielded relevant literature for this review. LDL-hypercholesterolemia, hypertriglyceridemia, mixed hyperlipoproteinemia, and low HDL cholesterol are the most common lipid metabolism disorders. Lipoprotein(a) levels can also be raised, either alone or in combination with other lipid metabolism diseases. An LDL-cholesterol target number should be determined based on the overall cardiovascular risk, according to current European standards. The goal value should be set at 70 mg/dL (1.8 mmol/L) if the risk is exceedingly high, such as in patients with established atherosclerosis. Higher target levels can be set if the risk is lower: 100 mg/dL (2.6 mmol/L) or 115 mg/dL (3.3 mmol/L). Patients with hypertriglyceridemia and mixed disorders of lipid metabolism benefit from lifestyle change the most.
Statins are by far the most important type of medication for lowering LDL cholesterol levels. Ezetimibe can be given instead of statins to patients who can't handle them or whose cholesterol levels aren't low enough. Since the autumn of 2015, PCSK9 antibodies have been released; they can reportedly reduce LDL cholesterol levels by more than 50%, although no endpoint trials have yet been reported. They should only be administered to carefully selected patients at this time. In monotherapy trials, fibrates and omega-3 fatty acids were found to reduce cardiovascular events, but when combined with statins, there was no additional effect. However, the trials' design was flawed, and the effectiveness of such combinations in individuals with combined abnormalities of lipid metabolism or hypertriglyceridemia has yet to be determined.
Conclusion
Hypercholesterolemia and the risk of vascular and cardiovascular events have a causal link. LDL cholesterol decrease lowers the risk of cardiovascular events. Since Anitschkow published the results of his research in 1913, there has been a strong link between hypercholesterolemia and atherosclerosis (1). However, only in the last 20 years has the therapeutic potential of this link been completely realized (2). Despite the fact that the first successful study on lipid-lowering drugs was conducted 50 years ago, the 4S study, the first large-scale trial of statins, was published in 1994. (3). The use of statins to lower LDL cholesterol is a powerful method for both primary and secondary prevention of cardiovascular disease (4). Statins are now the standard treatment for all types of atherosclerosis and are also given for primary prevention in the presence of the associated risk factors (5). Although the evidence is compelling, each case must be evaluated individually to determine whether or not an individual would benefit from lipid-lowering and which technique to take. The goal of this article is to provide answers to these issues so that lipid-lowering drugs are not misused, overused, or inappropriately used.
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