Protocolo terapéutico de la dislipidemia: prevención primaria y secundaria

Abstract

In the treatment of dyslipidemia, a distinction is made between primary and secondary prevention. Treatment always includes a healthy diet, regular exercise, and lifestyle modifications. The lipid control objectives in primary prevention are determined by risk scales, while in secondary prevention, a double therapeutic objective is sought: an LDL level of less than 55 mg/dl and a reduction of at least 50% compared to the baseline LDL level. Statins, ezetimibe, bempedoic acid, and proprotein convertase subtilisin/kexin type 9 inhibitors are the different pharmacological treatment options. Hypertriglyceridemia in primary prevention is not a therapeutic objective except in cases of severe hypertriglyceridemia (greater than 500 mg/dl) to avoid the development of pancreatitis; in patients with levels of 200–500 mg/dl, it depends on the cardiovascular risk. Icosapent ethyl is an option to consider in secondary prevention in patients with triglyceride levels above 150 mg/dl and good LDL control.