[Management of dyslipidemia].

There is now an enormous amount of literature on the relationship between blood lipids and coronary artery disease. It is clear that the treatment by modification of the diet and hypolipidaemic drugs is associated with a decrease of the coronary events. However there is no cure for any of the primary dyslipidemias and relative treatment involves a life-long commitment by the patient. In addition the efficiency of the treatment is dramatically different in patients at very high risk (secondary prevention, combination of several risk factors) and in those at moderate risk. Furthermore, patient's compliance is usually low. Therefore management of the hyperlipidaemic patients requires a rigorous approach to evaluate the global risk and consequently to adapt the treatment at an individual level. We describe here our outpatient clinic in which about 6000 hyperlipidaemic patients have been referred. We indicate the strategy that we used for taking care the patients including 1) the education of the subjects 2) the detection of secondary hyperlipidaemia 3) the evaluation of the global risk including non-invasive evaluation of the atherosclerosis and the results of such approach (for example, we found a much higher percentage of positive exercise ECG in patients with carotid atherosclerosis in our ultrasonographic examinations.