New choles­terol guide­lines push per­son­al­ized care

The Idaho Statesman (Sunday) - - NEWS -

Lead­ing heart ex­perts re­leased new choles­terol man­age­ment guide­lines Satur­day that call on doc­tors to tailor treat­ment to more per­son­al­ized risk as­sess­ments of each pa­tient and rec­om­mend the use of two new kinds of drugs for those at the great­est dan­ger of dis­ease.

The rec­om­men­da­tions build on guide­lines is­sued in 2013 that fun­da­men­tally al­tered the way health care providers de­ter­mine a pa­tient’s risk of heart at­tack and car­dio­vas­cu­lar dis­ease. In that wa­ter­shed doc­u­ment, the ex­perts told doc­tors to stop try­ing to lower pa­tients’ choles­terol num­bers to spe­cific tar­gets and in­stead fol­low an over­all ma­trix that tries to pre­dict their fu­ture risk of prob­lems.

The new guide­lines give clin­i­cians a bet­ter idea of how to do that via treat­ment cat­e­gories that vary de­pend­ing on choles­terol scores and, if nec­es­sary, other tests. The 121-page doc­u­ment was un­veiled Satur­day at the Amer­i­can Heart As­so­ci­a­tion’s 2018 Sci­en­tific Ses­sions in Chicago and pub­lished in the Jour­nal of the Amer­i­can Col­lege of Car­di­ol­ogy and the heart as­so­ci­a­tion’s jour­nal, Cir­cu­la­tion.

“We es­sen­tially are en­dors­ing and ex­pand­ing the scope of the risk dis­cus­sion,” said Neil Stone, vice-chair­man of the com­mit­tee that wrote the guide­lines and a car­di­ol­ogy pro­fes­sor at North­west­ern Univer­sity’s Fein­berg School of Medicine.

For ex­am­ple, the guide­lines rec­om­mend “high­in­ten­sity” ther­apy with statins for peo­ple un­der the age of 75 who are de­ter­mined to have atheroscle­rotic car­dio­vas­cu­lar dis­ease, with the goal of re­duc­ing their LDL, or “bad,” choles­terol by 50 per­cent.

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