Combination Therapy versus Monotherapy for Dyslipidemia : Are 2 Pills Better than 1 ?

Accumulating clinical trial evidence and recently updated national guidelines support more aggressive efforts to reduce levels of circulating atherogenic lipoproteins. To meet the new, intensified low-density lipoprotein cholesterol goals issued by the Third Adult Treatment Panel of the National Cholesterol Education Program, dyslipidemic patients at high cardiovascular risk may require reductions in low-density lipoprotein cholesterol levels that exceed 50%. Combination drug therapy can help in reaching greater decreases in low-density lipoprotein cholesterol than monotherapy and improve other lipid parameters, including triglycerides and high-density lipoprotein cholesterol. However, it may also increase the side effects and costs, and reduce compliance. The initial choice of an effective statin may be an important first step in planning safe, aggressive, and cost-effective lipid reductions.