American Heart Association Updates Cholesterol Guidelines

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More personalized risk assessments and new cholesterol-lowering drug options for people at the highest risk for cardiovascular disease are among the key recommendations in the 2018 cholesterol guidelines from the American Heart Association.

High cholesterol, at any age, can increase a person’s lifetime risk for heart disease and stroke. A healthy lifestyle is the first step in prevention and treatment to lower that risk.

The 2018 guidelines recommend more detailed risk assessments to help health care providers better determine a person’s individualized risk and treatment options.

In some cases, a coronary artery calcium score can help determine a person’s need for cholesterol-lowering treatment, if their risk status is uncertain or if the treatment decision isn’t clear.

While statins are still the first choice of medication for lowering cholesterol, new drug options are available for people who have already had a heart attack or stroke and are at highest risk of having another.

For those people, medication should be prescribed in a stepped approach, first with a maximum intensity statin treatment, adding ezetimibe if desired LDL cholesterol levels aren’t met and then adding a PCSK9 inhibitor if further cholesterol reduction is needed.

The guidelines were presented on November 12 at the Association’s 2018 Scientific Sessions conference in Chicago, the premier annual global forum for the exchange of the latest advances in cardiovascular science for researchers and clinicians.

The guidelines were simultaneously published in the American Heart Association journal, Circulation and the Journal of the American College of Cardiology.

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