New Dyslipidemia Tx Recommendations: Risk, Regimen, Goals

A summary highlighting key aspects of care that provide a thorough supplement and direction for clinicians treating patients with dyslipidemia was released by the National Lipid Association (NLA).

An expert panel, consisting of NLA members created this document with the intention to harmonize guidelines that have been presented in the past by the ATP panel, the American Heart Association (AHA)/American College of Cardiology (ACC), and those also released in the international community.

The recommendations clearly state that clinicians should assess patient risk and be able to identify a treatment regimen that gets the patient to well established goals. While the NLA encourages adoption and use of these recommendations, it recognizes that clinical judgment and evolving evidence constantly need to be incorporated to fortify clinician approaches to patient care.

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Highlights of the recommendations for patient-centered treatment of dyslipidemia include:

Assessing Risk

• Risk identification is the first crucial step to arrive at appropriate decisions by the health care provider and the patient to initiate healthy lifestyle changes and, potentially, drug therapy. The highest risk patients for future cardiovascular disease (CVD) events will always be those with established atherosclerotic cardiovascular disease (ASCVD).
• In primary prevention situations, the presence of 3 or more major risk factors, familial hypercholesterolemia (FH) and simultaneously occurring high-risk disease states (such as diabetes and chronic kidney disease) are to be considered high-risk status.
• Risk calculators can be confusing for many clinicians but can be beneficial when addressing patients that fall in the moderate risk group. The Framingham Risk Score 10-year hard coronary heart disease (CHD) endpoints is the preferred one for clinical decisions. Lifetime risk can also be used for patients under 50 years old.

Measures and Goals

• Non-HDL-C and LDL-C are the clinical measures of atherogenic lipoprotein contribution to ASCVD risk, and these parameters should be obtained in the baseline assessment and as targets of treatment.
• Clinicians should always steer therapy toward meeting goals, including lifestyle choices like diet and exercise, and include therapeutics when necessary to achieve the stated goals.

For more information visit Lipid.org.