The importance of diet and body activity which are the primary determinant of serum lipid levels is mentioned in a cursory fashion in this global guideline meant to control the total cholesterol load and atherosclerosis of our population. and exercise just once in the entire document !.To confirm my assumption I did a curious word search in this 85 page document. There is generally no need to to monitor the lipid levels as long as patient is comfortable.ĭisclaimer : *Sorry, the Intention is not to hurt the hard work of a elite panel who toiled for years to bring this much awaited guidelines on lipids and atherosclerosis! but to express my view, biased though !) If your answer is yes, administer the statin not in low dose but in moderately high dose ! (It appears there is little role for low intensity statins ) Whether they can some how benefit from taking statins ? “ “All healthy and unhealthy human beings should ask only one question What if, a new drug comes and statin is proved not an angel in our fight against the evil of atheroscerosis ! It seems to revolve around a single point agenda, how to fit a single drug called statin in the scheme of things ! In whatever way I look at it ,It keeps both physicians and their patient population guessing in a confused sate regarding their cholesterol levels the treatment modalities ! High-intensity statin use increased in the VA following release of the American College of Cardiology/American Heart Association cholesterol treatment guidelines, although disparities persist for certain patient groups including older adults, women, and certain minority groups.I share my thoughts after going through this 85 page land mark document ! Academic teaching hospitals and hospitals on the West Coast were more likely to intensify statins after release of the new guidelines. Groups less likely to undergo statin intensification were older adults (odds ratio=0.78 for each 10-year increase, 95% CI 0.76-0.81), women (odds ratio=0.86, 95% CI 0.75-0.99), and certain minority groups. However, statins at any intensity reduce CVD risk compared with no treatment. Advise that: High intensity statin treatment is the most clinically effective option for the prevention of cardiovascular disease (CVD). Among those on low- or moderate-intensity statin therapy, 15.6% were intensified to a high-intensity statin after guideline release. Discuss the risks and benefits of statin treatment so that the person can make an informed choice about their treatment. High-intensity statin use was lowest in Hispanics and Native Americans, although all groups showed an increase over time. Overall, high-intensity statin use increased from 28% to 35% after guideline release. The study sample included 331,927 and 326,759 eligible adults with ASCVD before and after the release of the new guidelines, respectively. People with an LDL cholesterol level of 190 milligrams per deciliter (mg/dL) or higher, due to a genetic condition. Overall, 22.5 of the cohort were on a high-intensity statin, 27.6 were on a low- or moderate-intensity. Results: Of the 601,934 patients with established ASCVD, 41.7 were female, and the mean age was 67.5 13.3 years. We identified those on high-intensity statin therapy (atorvastatin 40 mg or 80 mg, rosuvastatin 20 mg or 40 mg, and simvastatin 80 mg) during the 6 months after the index date. Guidelines from the American College of Cardiology and American Heart Association recommend statin therapy for: Secondary prevention in people with established atherosclerotic cardiovascular disease. Multivariable logistic regression was used to determine independent associations with statin use of varying intensities. If you do have a cardiovascular disease the aim, if possible, is to reduce total cholesterol (TChol) to less than 4.0 mmol/L and LDL cholesterol to less than 2.0 mmol/L. Patients with known ASCVD should receive high-intensity statins unless they fall into special categories (e.g., older age) or do not tolerate high-intensity statins, in which case. We examined administrative data from the VA 12 months prior to the index dates of April 1, 2013, and after April 1, 2014, to identify patients ≤75 years of age with ≥2 codes for ASCVD. This is a high-intensity statin - the aim of giving high-intensity statins is to reduce your low-density lipoprotein (LDL) cholesterol by at least 40. We sought to determine how these guidelines are being adopted at the Veterans Affairs (VA) Health System and identify treatment gaps. The November 2013 American College of Cardiology/American Heart Association cholesterol guidelines recommend the use of high-intensity statins for patients with atherosclerotic cardiovascular disease (ASCVD).
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