Therapy
Nourishment
After a nutritional protocol has been established, it is easy to identify the “sins” and to develop a modification of the lifestyle.
Medicinal
If sufficient nutritional change is not sufficient to reach the appropriate target values (table), additional (combination) drug therapy is required.
If a vascular event has already occurred, the drug therapy must be initiated
immediately and maintained for a period of time (under regular control).
arget values of lipid therapy
| Parameter | Prevention | Therapy |
| CH | < 200 | < 160 |
| HDL | > 50 | > 50 |
| LDL² | < 130 | < 100 |
| CH/HDL | < 5 | < 3 |
| TG | < 200 | < 200 |
| Lp(a) | < 30 | < 30 |
| non-HDL-CH*² | < 160 | < 130 |
| non HDL-Lp**² | < 190 | < 160 |
CH = Cholesterol;
HDL = high-density Lipoprotein;
LDL = low-density Lipoprotein;
TG= Triglyceride;
Lp(a) = Lipoprotein(a);
all limits (except CH/HDL) in mg/dl;
CH: 1 mmol/l = 38.7 mg/dl;
TG: 1 mmol/l = 88.6 mg/dl;
* non-HDL-Cholesterol (Cholesterol – HDL cholesterol) is easier and cheaper to calculate than LDL cholesterol for risk assessment (assessment of a future vascular event or death);
** the inclusion of Lp (a) for which a value of max. 30 mg / dl is the best way to take into account the risk of increased Lp (a) for the therapy decision;
¹optimal: < 150; ²30-er Regel (Differenz Primär- vs. Sekundärprävention)ptimal: < 150; ²30 Rule (Difference between primary and secondary prevention)
Lipoprotein Apheresis
In those patients (extremely rare cases) who are unable to achieve the appropriate target values with a dietary and combined drug therapy, lipoproteinapheresis (blood wash) is required.
This is usually done at weekly intervals at specialized centers, such as: at ATHOS.
