Hypercholesterolemia and atherosclerosis: Present and future therapy including LDL‐apheresis

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Abstract
Atherosclerosis‐induced coronary heart disease remains the major cause of death and disability in industrialized countries. Hypercholesterolemia is recognized as a causative factor in the development of atherosclerosis. While the lowering of cholesterol levels as a treatment goal has met with general agreement and acceptance, the preferred methods for doing so are still open to conjecture. This literature review discusses various factors in the hypercho‐lesierolemia‐atherosclerosis link and surveys a variety of treatment protocols including diet modification, drug therapy, surgical intervention, and plasmapheresis. Evidence is accumulating to prove that the ideal hypercholes‐terolemia therapy is one that reduces LDL levels while maintaining or increasing HDL levels. Because LDL‐apheresis has this potential, this paper also reviews the various LDL‐apheresis methods, including immunoadsorp‐tion, chemical affinity,' and double‐membrane filtration.