Greatly improved new statin guidelines – with one exception

The Twitterverse blew up yesterday when they released the new lipid guidelines. I read many articles and finally think I am understanding the big progress these guidelines achieve. My favorite review is on Medscape (free registration required) – New Cholesterol Guidelines Abandon LDL Targets. I titled this post the statin guidelines, because these guidelines no longer focus on LDL levels, but rather the use of statins. We are no longer asked to treat to goal, rather to put appropriate patients on a statin. The four major primary- and secondary-prevention patient groups who should be treated with statins were identified on the basis of randomized, controlled clinical trials showing that the benefit of treatment outweighed the risk of adverse events. The four treatment groups include: 1. Individuals with clinical atherosclerotic cardiovascular disease. 2. Individuals with LDL-cholesterol levels >190 mg/dL, such as those with familial hypercholesterolemia. 3. Individuals with diabetes aged 40 to 75 years old with LDL-cholesterol levels between 70 and 189 mg/dL and without evidence of atherosclerotic cardiovascular disease. 4. Individuals without evidence of cardiovascular disease or diabetes but who have LDL-cholesterol levels between 70 and 189 mg/dL and a 10-year risk of atherosclerotic cardiovascular disease >7.5%. Obviously these groups differ in many ways from current guidelines. The writing panel acknowledged that they had no outcome evidence for ...
Source: DB's Medical Rants - Category: Health Medicine and Bioethics Commentators Authors: Tags: Medical Rants Source Type: blogs