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Posted by on Oct 8, 2016 in Coronary artery disease | 0 comments

In a nutshell

This paper reviews the recent United States guidelines on recommendations for managing cholesterol levels. 

Some background

High levels of cholesterol (type of fat) increases the risk of heart disease. Cholesterol levels can be changed, and medical treatment can help to lower cholesterol levels. Statins, for example, are a group of drugs that lower cholesterol levels in the body. 

The American College of Cardiology and American Heart Association came out with guidelines for the treatment of cholesterol in 2013. 

Methods & findings

The current article reviewed the updated American guidelines, and compared them to guidelines set by other countries.

These guidelines recommended treatment with statins for 4 groups of people. Statins are recommended for people with atherosclerotic cardiovascular disease (build-up of fat in the blood vessels of the body). Statins are recommended for those with low density lipoprotein- C (LDL-C; type of cholesterol) of 190 mg/dL or more. Statins are recommended for those with diabetes mellitus and with LDL-C of 70-189 mg/dL. Statins are recommended in those without diabetes mellitus, with LDL-C of 70-189 mg/dL and at least 7.5% risk of atherosclerotic cardiovascular disease in 10 years.

Statin treatment can reduce LDL-C levels by 30% to even more than 50% with intense statin treatment. They also recommend that levels of fat in the body should be regularly monitored.

In comparison, the National Institute for Health and Care Excellence, based in England, set guidelines in 2014. These guidelines recommend statin treatment for those with type 2 diabetes mellitus. Statin treatment is also recommended for patients older than 40 with either type 1 diabetes mellitus of more than 10 years or with organ damage.

It also recommends statins for those without diabetes mellitus but with a 10-year risk of cardiovascular disease of 10% or more.  Atorvastatin (Lipitor) 20 mg daily is recommended to prevent cardiovascular disease from occurring.  Atorvastatin 80 mg daily is recommended to prevent disease from worsening in those with cardiovascular disease. In those with chronic kidney disease, 20 mg of atorvastatin is recommended.

The bottom line

The authors concluded that statin use is recommended to prevent heart disease from occuring and progressing, with differences in specific treatment guidelines for different countries.

What’s next?

Talk to you doctor about whether you need medication for lowering cholesterol levels. 

Published By :

Circulation

Date :

May 03, 2016

Original Title :

Recent Update to the US Cholesterol Treatment Guidelines: A Comparison With International Guidelines.

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