American College of Cardiology (ACC)/American Heart Association (AHA) released new Guidelines on the Treatment of Blood Cholesterol last week.
The biggest change in the new guidelines is : “there is no target level of cholesterol to be achieved by the drugs.” Lower levels of cholesterol are better but no particular level is found to be protective. So, the following are no longer considered appropriate strategies: treat to target, lower is best, treat to level of cardiovascular disease risk, and based upon lifetime risk of cardiovascular disease.
Through a rigorous process, four groups of individuals were identified, who would benefit the most with anti-cholesterol drugs called Statins.
Four Statin Benefit Groups:
• 1) Individuals with clinical atherosclerotic disease: coronary artery disease, stroke, or any vascular disease.
• 2) Individuals with elevations of low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dl.
• 3) Individuals 40-75 years of age with diabetes, and LDL-C > 70 mg/dl.
• 4) Individuals who have an estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk of 7.5% or higher.
Individuals in the fourth group can be identified by using the new Pooled Cohort Equations for ASCVD risk prediction, developed by the Risk Assessment Work Group. The 10 year- Cardiovascular Risk Calculator can be calculated by entering your values in the calculator which can be downloaded from the below mentioned site.
The dose of statin advised is either high or moderate in order to reduce LDL cholesterol level by > 50% and 30-50% respectively
Lifestyle modification (i.e., adhering to a heart healthy diet, regular exercise habits, avoidance of tobacco products, and maintenance of a healthy weight) remains a critical component of health promotion and ASCVD risk reduction, both prior to and in concert with the use of cholesterol-lowering drug therapies.
CardioSource – 2013 ACC AHA Guideline on the Treatment of Blood Cholesterol.