饮食中总脂肪和饱和脂肪的减少、超重患者的体重减轻、有氧运动以及向饮食中添加植物甾烷醇/甾醇可降低低密度脂蛋白胆固醇水平,并升高高密度脂蛋白胆固醇水平。[44]Huang J, Frohlich J, Ignaszewski AP. The impact of dietary changes and dietary supplements on lipid profile [in French]. Can J Cardiol. 2011 Jul-Aug;27(4):488-505.http://www.ncbi.nlm.nih.gov/pubmed/21801978?tool=bestpractice.com[45]Gupta AK, Savopoulos CG, Ahuja J, et al. Role of phytosterols in lipid-lowering: current perspectives. QJM. 2011 Apr;104(4):301-8.http://qjmed.oxfordjournals.org/content/104/4/301.longhttp://www.ncbi.nlm.nih.gov/pubmed/21325285?tool=bestpractice.com[46]Jenkins DJ, Jones PJ, Lamarche B, et al. Effect of a dietary portfolio of cholesterol-lowering foods given at 2 levels of intensity of dietary advice on serum lipids in hyperlipidemia: a randomized controlled trial. JAMA. 2011 Aug 24;306(8):831-9.http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2011.1202http://www.ncbi.nlm.nih.gov/pubmed/21862744?tool=bestpractice.com在美国,依洛尤单抗 (evolocumab) 被批准用于降低确诊心血管疾病成人患者的心肌梗死、卒中和冠状动脉血运重建的风险。
应评价患者是否存在额外的心血管危险因素,如吸烟和糖尿病,并开始适当的危险因素管理。