In individuals intolerant of the recommended intensity of statin therapy, use the maximally tolerated intensity of statin (COE = I LOE = B) Regularly monitor adherence to lifestyle and drug therapy every 3 to 12 months after adherence has been established continue assessment of adherence for optimal ASCVD risk reduction and safety (COE = I LOE = A) Increase statin intensity, or if on maximally tolerated statin intensity, consider addition of nonstatin therapy in select high-risk individuals§ (COE = IIb LOE = C).Evaluate for secondary causes of hyperlipidemia if indicated (see Table 6 in full guideline) (COE = I LOE = A).Reinforce improved adherence to lifestyle and drug therapy (COE = I LOE = A).Less than anticipated therapeutic response: For those with unknown baseline LDL-C, an LDL-C Insufficient evidence for LDL-C or non–HDL-C treatment targets from RCTs.Screen and treat type 2 diabetes according to current practice guidelines heart-healthy lifestyle habits should be encouraged to prevent progression to diabetes (COE = I LOE = B)Īnticipated therapeutic response: approximately ≥ 50% reduction in LDL-C from baseline for high-intensity statin and 30% to < 50% for moderate-intensity statin (COE = IIa LOE = B) Measure fasting lipid levels (COE = I LOE = A)ĭo not routinely monitor alanine transaminase or creatine kinase levels unless symptomatic (COE = IIa LOE = C) Regularly monitor adherence to lifestyle and drug therapy with lipid and safety assessmentsĪssess adherence, response to therapy, and adverse effects within 4 to 12 weeks following statin initiation or change in therapy (COE = I LOE = A) Statin therapy is not routinely recommended for individuals with New York Heart Association class II to IV heart failure or who are receiving maintenance hemodialysis Statin therapy may be considered in select individuals ‡ (COE = IIb LOE = C) 5% to 75 years, or ≥ 7.5% 10-year ASCVD risk: moderate- or high-intensity statin (COE = I LOE = A).Reemphasize heart-healthy lifestyle habits and address other risk factors To determine whether to initiate a statin, engage in a clinician-patient discussion of the potential for ASCVD risk reduction, adverse effects, drug-drug interactions, and patient preferences (COE = IIa LOE = C) Primary prevention: persons 40 to 75 years of age without diabetes and with LDL-C of 70 to 189 mg per dLĮstimate 10-year ASCVD risk using the risk calculator based on the Pooled Cohort Equations † in those not receiving a statin estimate risk every 4 to 6 years (COE = I LOE = B) Moderate-intensity statin (COE = I LOE = A)Ĭonsider high-intensity statin when ≥ 7.5% 10-year ASCVD risk using the Pooled Cohort Equations † (COE = IIa LOE = B) Primary prevention: persons 40 to 75 years of age with diabetes mellitus and with LDL-C of 70 to 189 mg per dL (1.81 to 4.90 mmol per L) Rule out secondary causes of hyperlipidemia (see Table 6 in full guideline)Īge ≥ 21 years: high-intensity statin (COE = I LOE = B)Īchieve at least a 50% reduction in LDL-C (COE = IIa LOE = B)Ĭonsider LDL-C–lowering nonstatin therapy to further reduce LDL-C (COE = IIb LOE = C) Primary prevention: primary LDL-C ≥ 190 mg per dL (4.92 mmol per L) ![]() Initiate or continue appropriate intensity of statin therapyĪge ≤ 75 years and no safety concerns: high-intensity statin (COE = I LOE = A)Īge > 75 years or safety concerns: moderate-intensity statin (COE = I LOE = A) Encourage heart-healthy lifestyle habits for all individuals
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |