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New Cholesterol Guidelines Published

Darrell Hulisz, RPh, PharmD

January 3, 2014

In November 2013, lipid lowering guidelines from the American College of Cardiology & American Heart Association were published in conjunction with the NHLBI.1 These guidelines update & replace the ATP3 guidelines & are based on higher quality evidence from more recent randomized controlled trials. Rather than focus on treating specific LDL targets, four groups of individuals are identified for whom sufficient evidence demonstrates a reduction in cardiovascular events, including coronary heart disease, cardiovascular deaths & stroke with a good margin of safety from statin therapy.

These four groups are:

  • 1) Individuals with clinical ASCVD (acute coronary syndromes, or a history of MI, stable or unstable angina, coronary or other arterial revascularization, stroke, TIA, or peripheral arterial disease presumed to be of atherosclerotic origin).
  • 2) Individuals with primary elevations of LDL Йф┤190 mg/dl.
  • 3) Individuals 40-75 years of age with diabetes, and LDL 70-189 mg/dl without clinical ASCVD.
  • 4) Individuals without clinical ASCVD or diabetes, who are 40-75 years of age with LDL 70-189 mg/dl & have an estimated 10-year ASCVD risk of 7.5% or higher. Lifestyle modification is recommended both prior to and in conjunction with the use of cholesterol-lowering drug therapies. Statin drugs are preferred over other lipid-lowering therapies.

1. Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz CN, Lloyd-Jones DM, Blum CB, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Journal of the American College of Cardiology (2013), doi:10.1016/j.jacc.2013.11.002 http://content.onlinejacc.org/article.aspx?articleid=1770217

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