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- Peter Alagona.
- The Milton S. Hershey Medical Center, Pennsylvania State Heart and Vascular Institute, H047, 500 University Dr, Hershey, PA 17033, USA. palagona@hmc.psu.edu
- Am J Manag Care. 2009 Mar 1; 15 (3 Suppl): S65-73.
AbstractManaged care initiatives to reduce cardiovascular disease (CVD) risk have, to date, focused almost exclusively on statins, which are primarily low-density lipoprotein cholesterol-lowering agents and have limited effects on triglycerides and high-density lipoprotein (HDL) cholesterol at commonly used doses. Significant residual CVD risk (ie, risk of recurrent CVD events) remains after treatment with statins and may stem, at least partially, from low HDL cholesterol and/or elevated triglycerides. Consequently, national treatment guidelines suggest that combination therapy may be necessary to address multiple lipid targets and adding niacin or a fibrate to a statin is a strategy to be considered. Recent clinical trial evidence has demonstrated the efficacy of niacin/statin and fenofibric acid/statin combination therapies in treating multiple lipid abnormalities.
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