What medicine to take for hyperlipidemia: the latest treatment options and medication guide
Hyperlipidemia is a common chronic metabolic disease, and its incidence has continued to rise in recent years with changes in lifestyle. According to hot spot data from the entire network in the past 10 days, patients are most concerned about drug selection, side effects and combination medication regimens. This article will provide you with structured answers based on the latest clinical guidelines and hot topics.
1. Classification of commonly used drugs for hyperlipidemia
| drug type | Representative medicine | Mechanism of action | Lipid lowering range |
|---|---|---|---|
| Statins | Atorvastatin, rosuvastatin | Inhibit cholesterol synthesis | LDL-C↓30-50% |
| Ezetimibe | Ezetimibe | Reduce intestinal absorption | LDL-C↓15-20% |
| PCSK9 inhibitors | alircumab | Enhance LDL clearance | LDL-C↓50-70% |
| fibrates | fenofibrate | Lower triglycerides | TG↓30-50% |
| fish oil preparations | EPA ethyl ester | Anti-inflammatory and lipid-regulating | TG↓20-30% |
2. Top 5 hotly discussed drugs in 2023
| Ranking | Drug name | Hot search index | focus |
|---|---|---|---|
| 1 | Rosuvastatin | 987,000 | Risk of liver and kidney damage |
| 2 | alircumab | 762,000 | Medical insurance reimbursement policy |
| 3 | fenofibrate | 654,000 | Diabetes combined medications |
| 4 | EPA ethyl ester | 531,000 | cardiovascular protection |
| 5 | Ezetimibe | 428,000 | combination medication regimen |
3. Personalized medication plans for different groups of people
According to the latest "China Blood Lipid Management Guidelines (2023)" recommendations:
1. Simple hypercholesterolemia:Moderate-strength statins (such as atorvastatin 20 mg) are preferred. If the effect is not good, ezetimibe 10 mg can be used in combination.
2. Mixed hyperlipidemia:Statins + fenofibrate (taken 12 hours apart), recent studies have shown that combined treatment can reduce TG by an additional 35%.
3. Familial hypercholesterolemia:The combination regimen of statin + PCSK9 inhibitor is recommended. Clinical data shows that it can reduce LDL-C to less than 1.4mmol/L.
4. Elderly patients:Choose a hydrophilic statin such as pravastatin, the starting dose is halved, and creatine kinase needs to be monitored closely.
4. Medication precautions
| adverse reactions | prone drugs | Precautions | probability of occurrence |
|---|---|---|---|
| abnormal liver function | All statins | Test ALT before taking medication | 0.5-2% |
| muscle pain | Simvastatin | Supplement Coenzyme Q10 | 5-10% |
| gastrointestinal reactions | fenofibrate | Take after meal | 3-5% |
| elevated blood sugar | high intensity statin | Monitor HbA1c | 9-12% |
5. Progress of new drugs in 2023
1.Inclisiran:The world's first siRNA lipid-lowering drug requires only two injections per year. Phase III clinical trials have shown that LDL-C can be continuously reduced by 52%.
2.Bempedoic acid：A new ATP citrate lyase inhibitor that can additionally reduce LDL-C by 28% when combined with a statin.
3.Evinacumab:ANGPTL3 inhibitor, targeting homozygous familial hypercholesterolemia, can reduce LDL-C by 49%.
6. Lifestyle intervention suggestions
Medication treatment needs to be combined with: 30 minutes of aerobic exercise per day, Mediterranean diet (30g of nuts per day, deep-sea fish twice a week), smoking cessation and limiting alcohol. Research shows that comprehensive management can reduce the risk of cardiovascular events by 57%.
Reminder: Specific medication needs to be evaluated by a professional doctor, and the data in this article are for reference only. During the period of medication, blood lipids, liver and kidney functions should be reviewed regularly, and if myalgia or fatigue occurs, seek medical attention promptly.
check the details
check the details
en
