More Nuanced Guidelines for Lipid Lowering to Prevent CVD
Am Fam Physician. 2016 Jan 1;93(1):59.
For the primary and secondary prevention of cardiovascular disease (CVD), how should risk be assessed, and what should be done about elevated lipid levels?
The authors of this guideline give a more nuanced and less aggressive approach to lipid lowering than other groups. For the primary prevention of CVD, check blood pressure and lipids (nonfasting is fine) to calculate the 10-year CVD risk. If greater than 12%, treat; if 12% or less, discuss treatment with the patient. Pick a moderate-dose statin and do not check lipid levels again. For secondary prevention, use moderate-dose statins and titrate to a higher dose only in a few high-risk patients. Again, do not titrate based on lipid levels. (Level
POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.
For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.
To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.
This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.
A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.
Want to use this article elsewhere? Get Permissions