- Use of high-intensity statin therapy for people under the age of 75 who have atherosclerotic cardiovascular disease. The goal should be to reduce their LDL by 50%.
- Use of moderate-intensity statin therapy in people aged 40 to 75 with diabetes. This should be done regardless of their 10-year risk of disease.
- Stick to the guiding principle that lower is better as far as LDL is concerned. Emphasise on the importance of a healthy living lifestyle - exercising and eating healthy. Blood pressure should be controlled, and smoking should be discouraged.
- Use of preventive treatment for people who might be at risk of disease. Ezetemibe should be the drug of choice in patients who have suffered a heart attack or have multiple high-risk conditions.
- Coronary artery calcium tests should be used in patients who are at intermediate risk and when a decision about statin therapy is uncertain. Statin therapy may be withheld if CAC is zero except in smokers, patients with diabetes and those with a strong history of premature ASCVD. It is interesting to note that coronary artery calcium scoring was deemphasised in the 2013 cholesterol guidelines but this changes with the new guidelines.
- Continuous monitoring cholesterol is encouraged, and it is recommended that patients on statin therapy should be assessed every 4 to 12 months.
#AHA18: Just in - new cholesterol management guidelines
Published on : Sat, 10 Nov 2018
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