ITEMS IN AFP WITH KEYWORD:
Oct 15, 2012 Issue
Should Family Physicians Routinely Screen for Hypercholesterolemia in Children? Yes: The Evidence Supports Universal Screening [Editorials: Controversies in Family Medicine]
Yes: The Evidence Supports Universal Screening. Atherosclerotic cardiovascular disease events are the culmination of a process that has clearly been shown to begin in childhood, with accumulation of abnormal lipids in the vascular intima.
Trials to date have found that statins reduce all-cause mortality, composite cardiovascular outcomes, and revascularization. However, most trials included large numbers of persons with known CVD. Clear evidence of the effectiveness of statins to prevent a first cardiovascular event is lacking.
Pharmacologic treatment of hyperlipidemia in conjunction with therapeutic lifestyle changes can be used for both primary and secondary prevention of cardiovascular disease. Statins have the most convincing data for primary prevention, especially for higher risk patients. Therefore, risk stratificati...
What are the effects of pharmacologic cholesterol-lowering interventions in persons at low, medium, and high risk of CHD? What are the effects of a reduced- or modified-fat diet in persons at risk of CHD?
Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. The risk of hepatic injury caused by statins is estimated to be about 1 percent, similar to that of patients taking a placebo. Patients with transaminase levels no m...
Feb 1, 2011 Issue
Should We Treat Moderately Elevated Triglycerides? No: Reducing Moderately Elevated Triglycerides Is Not Proven to Improve Patient Outcomes [Editorials: Controversies in Family Medicine]
Moderately elevated triglyceride levels have not been established as an independent risk factor for CHD. More importantly, the lowering of moderately elevated triglyceride levels with drug therapy has not been shown to decrease the rate of CHD for primary prevention in otherwise healthy individuals.
Feb 1, 2011 Issue
Should We Treat Moderately Elevated Triglycerides? Yes: Treatment of Moderately Elevated Triglycerides Is Supported by the Evidence [Editorials: Controversies in Family Medicine]
Nov 1, 2010 Issue
For Hyperlipidemia, Go Where the Evidence Takes You: Give a Statin and Nothing Else [Editorials: Controversies in Family Medicine]
Only statins have patient-oriented evidence supporting their role in reducing all-cause mortality. The NCEP–ATP III guidelines offer a nine-step approach for reaching target lipid levels, but the application to everyday practice is far simpler: If a patient with hyperlipidemia has coronary disease, prescribing a statin is the obvious choice.
Nov 1, 2010 Issue
The Role of Nonstatin Therapy in Managing Hyperlipidemia [Editorials: Controversies in Family Medicine]
When treating hyperlipidemia, physicians often face the question of the clinical value of nonstatin drugs, including bile acid sequestrants, fibrates (fibric acid derivatives), niacin, and cholesterol-absorption inhibitors. This editorial highlights the most prominent trial data and examines the mer...
Sep 1, 2010 Issue
Hyperlipidemia Treatment in Children: The Younger, the Better [Editorials: Controversies in Family Medicine]
Despite the absence of data in children demonstrating morbidity and mortality reduction by aggressive treatment of lipid disorders, the overwhelming data in adults (e.g., decreasing LDL cholesterol, improved morbidity and mortality) and evidence of atherosclerotic lesions developing in childhood support the argument for early treatment.