ITEMS IN AFP WITH KEYWORD:
Oct 15, 2017 Issue
Screening for Lipid Disorders in Children and Adolescents [Putting Prevention into Practice]
A healthy 12-year-old boy presents for a school physical and well visit. His family history reveals that his maternal grandfather had a heart attack at 75 years of age and that his 52-year-old father has started taking a medication for elevated cholesterol levels.
Jan 15, 2017 Issue
Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: (1) they are aged 40 to 75 ...
Review recommendations from two major guidelines on lipid-lowering drugs for the primary and secondary prevention of atherosclerotic cardiovascular disease events. Statins are preferred, although nonstatins may be appropriate in specific cases.
Statins will long remain the cornerstone of treatment because of their proven benefits and cost-effectiveness, especially in the four statin benefit groups. However, emerging RCT evidence shows that the degree of LDL-C lowering may be more important than the drug used to achieve it.
Dec 15, 2016 Issue
Screening for Lipid Disorders in Children and Adolescents: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger.
Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.
Alirocumab is a novel lipid-lowering therapy that is highly effective at lowering LDL cholesterol when used in addition to statin therapy and diet. Its use should be limited to patients with either heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who do not tolerate an adequate dose of a statin.
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.
The Blood Cholesterol Expert Panel from the American College of Cardiology (ACC) and the American Heart Association (AHA) issued an updated evidence-based guideline in 2013 that addresses the use of fixed doses of cholesterol-lowering drugs (statins) to reduce the risk of ASCVD in adults 21 years and older.
The new guideline from the ACC/AHA increases the number of adults between 40 and 75 years of age who are eligible to take statins by 12.8 million. The largest increases were among adults who would take statins for primary prevention and for adults between 60 and 75 years of age. The authors estimate...