Background: Coronary artery disease is a common comorbidity encountered during
the perioperative period. Whether patients are scheduled for cardiac or noncardiac surgery, this
cardiovascular disease must be addressed in the preoperative period to decrease the accompanying
risks and potential postoperative problems. Lipid-lowering medications are often used to treat
hyperlipidemia, a risk factor for the development of atherosclerosis and coronary artery disease.
Objective: To discuss the medications most commonly used to treat hyperlipidemia and to describe
strategies for handling these treatment regimens in the perioperative period.
Method: An online search of studies and review articles was conducted through PubMed and Medline
that addressed pharmacology and perioperative management of hyperlipidemia medications.
Results: Statins are the most commonly prescribed lipid-lowering agents, with benefits that extend
beyond correcting lipid levels. However, statins can have clinically significant adverse effects that
may necessitate the use of other lipid-lowering medications with different mechanisms of action.
Alternative medications such as nicotinic acid and omega-3 fatty acids should be withheld in the
preoperative period because these agents have been associated with hypotension and increased
Conclusion: Clinicians must be familiar with the various lipid-lowering agents because it is very
likely they will encounter such medications during preoperative visits.