Biomarkers for cholesterol absorption and synthesis in hyperlipidemic patients: role for therapeutic selection.

Increased total serum cholesterol and low-density lipoprotein cholesterol concentrations are associated with atherosclerosis and risk for myocardial infarction and stroke. Those who have high cholesterol with other factors that predispose them to cardiovascular disease should be treated with cholesterol-lowering medications. The pathophysiology of hyperlipidemia is important in the proper selection of drug therapy. Patients who have increased cholesterol synthesis should be medicated with drugs that reduce in vivo cholesterol production, whereas those who have increased dietary absorption of cholesterol should be treated with drugs that inhibit dietary absorption. Sterol-based biomarkers are available to assess the cause of hypercholesterolemia and may have an impact on therapeutic selection.