Niacin and fibrates in atherogenic dyslipidemia: pharmacotherapy to reduce residual cardiovascular risk.

Chapman MJ, Redfern JS, McGovern ME, Giral P. Niacin and fibrates in atherogenic dyslipidemia: pharmacotherapy to reduce residual cardiovascular risk. Pharmacol Ther 2010;126 :314-345

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The current pandemic of obesity, metabolic syndrome, and type 2 diabetes is intimately associated with an atherogenic dyslipidemic phenotype featuring low HDL-C combined with elevated TG-rich lipoproteins and small dense LDL. The future treatment of atherogenic dyslipidemias involving the lipid triad requires integrated pharmacotherapy targeted not only to proatherogenic particles but also to atheroprotective HDL. In this context, there is renewed interest in pharmacotherapeutic strategies involving niacin and fibrates in monotherapy and in association with statins.