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New guidelines for cholesterol management require personal risk assessments

Leading Heart Experts released new guidelines for cholesterol management on Saturday, which urges doctors to tailor treatment to more personal…

Leading Heart Experts released new guidelines for cholesterol management on Saturday, which urges doctors to tailor treatment to more personal risk assessments by each patient and recommend the use of two new types of drugs for those with the greatest risk of disease.

recommendations based on guidelines issued in 2013 fundamentally changed how healthcare professionals determine the patient’s risk of myocardial infarction and cardiovascular disease. In the water protection document, experts said that doctors would stop trying to lower the patient’s cholesterol levels to specific targets and instead follow an overall matrix trying to predict their future risk of problems.

The new guidelines give clinics a better idea of ​​how to do it through treatment categories that vary depending on cholesterol and, if necessary, other tests. The 1

21-page document was presented on Saturday at the American Heart Association 2018 Scientific Sessions in Chicago and published in the Journal of American College of Cardiology and Heart Association Journal Circulation.

“We essentially support and expand the scope of the risk discussion,” said Neil J. Stone, vice chairman of the committee who wrote the guidelines and a cardiology professor at the Northwestern University’s Feinberg School of Medicine.

For example, the guidelines recommend “high intensity” statin treatment for people under the age of 75 who are determined to have atherosclerotic cardiovascular disease, with the goal of reducing their low density lipoproteins (LDL) or “bad” cholesterol by 50 percent. In people aged 40-75 years of diabetes, statin treatment with moderate intensity is indicated independently of the patient’s 10 year disease risk in accordance with another recommendation.

Heart disease is the American leading killer. Nearly a third of all American adults have high LDL levels, an important cause of fat loss in arteries that lead to myocardial infarction, stroke and other cardiovascular problems.

The new recommendations confirm the leading principles of heart health that “lower is better” In terms of LDL, and that people should try to achieve it first by living a healthy lifestyle that begins in childhood. It includes diet and exercise, control of blood pressure and avoidance of smoking among other measures.

When these steps are not sufficient, the guidelines again support statins as the cornerstone of preventive treatment for people at risk of disease. About 43 million people in the United States are taking statins to lower LDL levels. The drug is credited with reducing the risk of heart attacks and stroke.

Two drugs have been developed since the latest guidelines were issued in 2013, and the panel approved their use in cases where statins are insufficient. For people who suffer from a heart attack or are at risk of high risk, experts suggest adding ezetemibe. The drug, which is marketed as Zetia but also available in generic form, reduces the amount of cholesterol absorbed into the small intestine.

In some cases, experts also recommend the use of PCSK9 inhibitors, powerful drugs approved by the Food and Drug Administration in 2015 that block a substance that inhibits the liver’s ability to remove LDL from the blood. The drugs, which are mainly used to treat an hereditary disease that cause very early heart attacks, are extremely expensive and the panel offered doctors a way to assess their value.

The commission’s estimated PCSK9 inhibitor costs more than $ 150,000 for every good year of life added.

When a doctor has difficulty determining how to treat patients, the committee proposes coronary artery. Calcium tests may help to determine how much plaque has accumulated on the walls of some blood vessels. They increased the prospect of starting cholesterol testing much earlier in life to identify children at risk of developing heart disease.

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