Guidelines issued for management of dyslipidemias
MedWire News: The European Atherosclerosis Society (EAS) and the European Society of Cardiology (ESC) have issued new guidelines for comprehensive lipid control in Europe.
The aim of the guidelines was to "keep pace with emerging data and provide up to date treatment advice for a wide range of dyslipidemias, including diabetes and the metabolic syndrome."
The authors state that low-density lipoprotein (LDL) cholesterol should remain the "primary priority in lipid management."
They recommend that LDL cholesterol levels be kept below 3.0 mmol/l (115 mg/dl) in moderate-risk patients, 2.5 mmol/l (100 mg/dl) in high-risk patients, and 1.8 mmol/l (70 mg/dl) and/or at least 50% reductions in levels if this target cannot be met in very high-risk patients.
The guidelines state that lifestyle interventions, such as improving diet and exercising sufficiently, should be the first step for managing lipids in all patients. But if lipid targets are not met with lifestyle alone, treatment with statins should also be considered.
If LDL targets are still not met, or for patients who do not tolerate statins, the authors recommend alternative treatment methods such as combination therapy with a cholesterol absorption inhibitor, bile acid sequestrant, or nicotinic acid.
For patients who have their LDL cholesterol levels under control, but have elevated triglycerides (>1.7 mmol/l [150 mg/dl]), with or without low levels of high-density lipoprotein cholesterol, the team recommends that non-high-density lipoprotein cholesterol or apolipoprotein B should be secondary targets.
Furthermore, the guidelines stress that lipid-modifying treatment needs to be tailored to patients according to their total cardiovascular risk.
EAS chairperson of the task force, Olov Wiklund, from Gothenburg University in Sweden said: "These guidelines provide new insights into the complexity of dyslipidemia and more specific treatment advice for different clinical settings.
"A major impact will be on the treatment of dyslipidemia in the metabolic syndrome and in diabetes."
They conclude: "Successful implementation of these pivotal guidelines will help… to reduce the burden of CVD in Europe."
The guidelines are published in the European Heart Journal.
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By Nikki Withers