Posted by jayaram in Many authorities recommend screening asymptomatic individuals by measuring plasma cholesterol. A level less than 200 mg% is considered desirable, and a level over 240 mg% requires lipoprotein analysis, especially determination of LDL cholesterol. Reduction of LDL cholesterol depends on dietary restriction of cholesterol to less than 300mg day -1, of calories to attain ideal body weight, and of total fat intake to less than 30% of total calories. Approximately two-thirds of the fat should be mono- or polyunsaturated. The second line of therapy is with medicines. Cholestyramine and colestipol are bile salt-binding medicines that promote excretion of bile salts in the stool. This in turn increases the rate of hepatic bile salt synthesis and of LDL uptake by the liver. Lovastatin is an inhibitor of HMG CoA reductase. Since this enzyme is limiting for cholesterol synthesis, lovastatin decreases endogenous synthesis of cholesterol and stimulates uptake of LDL via the receptor. The combination of lovastatin and Cholestyramine is sometimes used for severe hyperlipidemia.