More Nuanced Guidelines for Lipid Lowering to Prevent CVD


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Am Fam Physician. 2016 Jan 1;93(1):59.

Clinical Question

For the primary and secondary prevention of cardiovascular disease (CVD), how should risk be assessed, and what should be done about elevated lipid levels?

Bottom Line

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.


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Oct 15, 2016

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