ITEMS IN AFP WITH KEYWORD:
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...
Aug 15, 2014 Issue
Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Yes: Implementing the New ACC/AHA Cholesterol Guideline Will Improve Cardiovascular Outcomes [Editorials: Controversies in Family Medicine]
The recommendations appropriately focus treatment on those most likely to benefit.
Aug 15, 2014 Issue
Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Not Completely: Why It Is Right to Drop LDL-C Targets but Wrong to Recommend Statins at a 7.5% 10-Year Risk [Editorials: Controversies in Family Medicine]
The recommendations should have paid more attention to the inherent uncertainties in risk estimates and the importance of individual patient circumstances and preferences.
Apr 15, 2014 Issue
Apolipoproteins for Cardiovascular Risk Assessment [FPIN's Clinical Inquiries]
Measurement of apolipoprotein B and apolipoprotein A-I is no better than traditional lipid measurements and should not be used to predict cardiovascular risk.
Supplementation with omega-3 fatty acids decreases triglyceride and very low-density lipoprotein cholesterol levels. However, it can also increase low-density lipoprotein (LDL) cholesterol levels. Treatment with omega-3 fatty acids does not decrease total mortality, cardiovascular events, or cancer ...
The Endocrine Society recently published evidence-based recommendations on the diagnosis and management of hypertriglyceridemia in adults. Contributing factors include overweight and obesity, physical inactivity, excessive alcohol intake, metabolic syndrome, type 2 diabetes mellitus, and certain gen...
Oct 15, 2012 Issue
Should Family Physicians Routinely Screen for Hypercholesterolemia in Children? No: Universal Screening has Uncertain Benefits and a High Risk of Harms [Editorials: Controversies in Family Medicine]
No: Universal Screening Has Uncertain Benefits and a High Risk of Harms. Atherosclerosis can be demonstrated in young arteries, and its development over time correlates with the presence of risk factors for the disease, including higher lipid levels. But the presence of this association should not prompt screening just because it is available.