There is evidence that therapy which lowers the lipid concentration reduces the progression of premature atheroma, particularly in those who suffer from the familial disorder, so reduces the risk of vascular heart disease and stroke. Treatment involves an appropriate diet, usually food that is not excessive in calorie content or carbohydrate and low in saturated fats. There are a number of drugs available for lowering the lipid content of the plasma such as statins, for example atorvastatin and simvastatin, anion-exchange resins including clofibrate, bezafibrate and gemfibrozil, as well as nicotinic acid; all lower plasma cholesterol and plasma triglyceride concentration through their effect on reducing the hepatic production of LIPOPROTEINS. Cholestyramine and colestipol bind bile salts in the gut and so decrease the absorption of the cholesterol that these bile salts contain – hence lowering plasma cholesterol concentrations. Probucol lowers plasma cholesterol concentrations by increasing the metabolism of low-density lipoproteins.

The statins (atorvastatin, cerivastatin, fluvastatin, pravastatin and simvastatin) inhibit an enzyme involved in synthesising cholesterol, especially in the liver. They are more effective than anion-exchange resins in lowering LDL (low-density lipoprotein) cholesterol – a form of low-density cholesterol carried in the bloodstream, high levels of which are believed to be the main cause of atheroma. Statins are, however, less effective than the clofibrate group in reducing triglycerides and raising HDL (high-density lipoprotein) cholesterol. While statins are now prescribed to many with raised lipids, there is evidence that even those with apparently normal lipid levels, but who have certain risk factors for heart disease, may avoid future problems by taking statins.