WASHINGTON (dpa-AFX) - The American College of Cardiology (ACC) and the American Heart Association (AHA), along with several partner organizations, have released updated guidelines for managing patients with dyslipidemia.
Rather than focusing only on LDL, or 'bad' cholesterol, and statin therapy, the new recommendations take a broader approach to preventing and treating cardiovascular diseases linked to the hardening and narrowing of arteries.
The guidelines, co-chaired by Dr. Pamela Morris of the Medical University of South Carolina and published in JACC and Circulation, reaffirm that statins remain the foundation of treatment. However, they also highlight the role of additional medications such as ezetimibe and PCSK9 inhibitors when further risk reduction is needed.
A key update is the strong recommendation to measure lipoprotein(a), or Lp(a), at least once in every adult's lifetime. This marker, assessed through a blood test, is genetically determined and can significantly influence the long-term risk of heart attack or stroke. Higher Lp(a) levels are associated with greater cardiovascular risk. In addition, apolipoprotein B testing is now more clearly positioned as a useful tool for improving risk assessment and guiding treatment decisions.
The guidelines noted that the use of coronary artery calcium (CAC) scoring has also been strengthened, particularly as a 'tie-breaker' in cases where treatment decisions are uncertain.
Another major shift is the recommendation to consider medication for lowering LDL cholesterol as early as age 30 if lifestyle changes alone are not sufficient.
'While we want to try to optimize healthy lifestyle habits as the first step to lower cholesterol, we realize that if lipid numbers aren't within the desirable range after a period of lifestyle optimization, we should consider adding lipid-lowering medication earlier than we would have considered 10 years ago,' Dr. Roger S. Blumenthal, chair of the guideline writing committee, said in a news release. 'Lower [LDL-C] for longer, just like lower blood pressure for longer, results in much greater protection against future heart attack and stroke risk.'
Overall, the guidelines emphasize starting prevention early. They highlight the importance of counseling and promoting healthy lifestyle habits from a young age, aiming to keep LDL cholesterol levels at or below 100 mg/dL for effective primary prevention and long-term heart health.
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