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New cholesterol guidelines offer different approaches

New cholesterol guidelines recommend a more personal approach to risk assessments, a recurring focus on LDL target levels, and new…

New cholesterol guidelines recommend a more personal approach to risk assessments, a recurring focus on LDL target levels, and new drug options for people at highest risk of cardiovascular disease.

New cholesterol rules recommend a more personal approach to risk assessments, a recurrent focus on LDL target levels and new drug options for those at greatest risk of cardiovascular disease. The guidelines were announced Saturday during the American Heart Association annual scientific conference.

The recommendations developed by the American Heart Association and the American College of Cardiology also discussed the value of using the Calonary Calcium Values ​​for some patients and extended age ranges for treatment.

“High cholesterol treatment is not a size that suits everyone, and this guideline strongly determines the importance of personal care,” said Michael Valentine, chairman of the American College of Cardiology, in a press release.

“Over the last five years, we have learned even more about new treatment options and what patients can benefit from them,” he said. “By providing a clinic treatment plan, we provide them with the tools to help their patients understand and manage their risk and live longer and healthier lives.”

Criticism of previous guidelines

The new recommendations deal with many of the problems. Discontinue when the guidelines were last updated five years ago.

These 2013 guidelines were difficult for several reasons, explained Dr. Steven Nissen, Chair of Cardiovascular Disease at Cleveland Clinic: The previous guidelines used a risk counter that released important components such as family history; They did not address the issue of people over 75 years or younger than 40 years. They overhyped the risks that many patients met while lowered the threshold needed to guarantee statin drug treatment; and they did away with LDL (bad) cholesterol levels, which helped patients to make meaningful goals.

People with LDL levels of 100 or less “tend to have lower frequencies of heart disease and stroke, which support a” lower is better “philosophy, according to a statement from the medical organizations about the new guidelines.

A level of over 160 is considered to be “very high” according to a release from Johns Hopkins Medicine, which also outlined the new guidelines. For patients with high risk, the recommendation is recommended to lower “bad” cholesterol to levels below 70 years.

If statin treatment fails to adequately reduce LDL levels, the new guidelines suggest that patients who already have myocardial infarction or stroke other drugs – ezetimibe, available as a generic – to the regimen. If that combination is not working properly for patients with very high risk, a PCSK9 inhibitor may be added.

The new method encourages increased collaboration between doctors and their patients. Doctors are encouraged to discuss a wide range of factors that may increase the risks, such as family history and ethnicity, as well as other conditions including metabolic syndrome, premature menopause and chronic renal disease.

Impact of High Cholesterol in All Age [19659008] Doctors are also invited to look at patient life and how high cholesterol takes a toll. Children born to special high-risk families can be tested when they are as young as 2. For most children, however, the recommendation is to have a first test between the ages of 9 and 11 and then a follow-up test between the ages of 17 and 21.

And just As the cholesterol content of younger people should not be ignored, the same applies to those over 75, says the new recommendations.

“They now recognize that it may be appropriate to treat older people,” Something they did not do in 2013, said Nissen, who was very critical of the last round of guidelines. “Today’s 75-year-old can live long.”

All these advances are good signs, “one step ahead,” said Nissen. “It took five years to solve the problems with the latest set of guidelines, but I’m glad they’ve been taken up.”

Nissen offered only a critique of the new recommendations: the proposal Coronary artery scale is used to determine the need for cholesterol lowering treatments in patients for whom the need is not clear. This place shows plaque buildup in arteries and is determined by a CT scan, which can cost between $ 800 and $ 1,000, he said.

“You radiate someone to decide if you are going to use a drug that costs as little as $ 3 a month, and you spend a lot of money to do that,” he says. “I just do not think it’s cautious.”

But other than this, Nissen is pleased. “The big picture is that this is a reasonable set of guidelines,” he said.

Heart disease is the leading cause of death in the United States, according to the US Center for Disease Control and Prevention. Cardiovascular disease, which includes conditions that cause heart attacks and stroke, accounts for more than 836,000 deaths per year, according to the American Heart Association and the American Stroke Association.

“Having high cholesterol at any age increases the risk significantly” Dr Ivor Benjamin , president of the American Heart Association, said in a written statement. “That’s why it’s so important that even at young age people follow a heart-healthy life style and understand and maintain healthy cholesterol levels. “

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