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In the new guidelines from the Swedish Medical Products Agency, an aggressive approach is recommended for the treatment of hyperlipidemia in all patients with manifest atherosclerotic disease. Patients with intermittent claudication should therefore receive lipid-lowering treatment on the same indications as patients with coronary artery disease. The present article reviews our knowledge of hyperlipidemia as a risk factor for the development of peripheral artery disease. Hyperlipidemia is frequently found in these patients and the most common lipid derangements are low levels of HDL-cholesterol and hypertriglyceridemia. Hard end-point data concerning morbidity and mortality during lipid-lowering treatment in this specific population is largely lacking, although previous studies indicate that lipid-lowering treatment slows the atherosclerotic process and induces pain relief.

Application of the techniques of molecular biology to the study of cholesterol and lipoprotein metabolism in recent years has led to a dramatic increase in our knowledge of this field. This brief review provides a general outline of normal lipoprotein and cholesterol metabolism; some recent advances in research are discussed, and the molecular defects present in hypobetalipoproteinaemia, familial apo B-100 deficiency, type III hyperlipoproteinaemia, and familial hypercholesterolaemia are described and their clinical relevance is discussed. New aspects are presented of the finely tuned regulation of cholesterol synthesis, and its importance in treatment of hypercholesterolaemia is discussed, as is its possible involvement in oncogen expression.