Role of fibrates in reducing coronary risk: a UK consensus

This paper presents the consensus reached by a panel of experts on the role of fibrates in reducing coronary heart disease (CHD). The emphasis is on the application of these agents in clinical practice. Evidence that low levels of high-density lipoprotein cholesterol (HDL-C) play a major role in the development of CHD, plus the roles of lifestyle modification and statin treatment in raising HDL-C, are briefly reviewed. Current thinking on single-agent and combination therapies with fibrates is discussed with particular relevance to patients with low baseline HDL-C - whether receiving statins or not - and those with features of the metabolic syndrome. Recommendations on the practical use of fibrates are made in the light of recently published international guidelines on HDL-C management and the relevant evidence base.