Abstract
In this NLA Roundtable four members of the writing committee join the Editor to discuss
the process of developing the AHA/ACC/Multisociety Cholesterol Guidelines, which were
unveiled in November 2018. They also provide personal insights on the finished product.
Highlights include 1) the committee's decision to summarize 10 take-home messages
providing rapid communication of key points, 2) emphasis on clinician -patient discussion,
which may bring up issues specific to women or other population groups at risk, 3)
personalizing risk with risk-enhancing factors such as LDL-C ≥ 160 mg/dl, metabolic
syndrome, chronic kidney disease, pre-eclampsia, premature menopause, high risk ethnicity,
inflammatory diseases, hypertriglyceridemia and in selected cases, Lp(a), hs-CRP and
apoB; 4) using coronary artery calcium scoring when a risk decision is uncertain in
intermediate risk patients 5) monitoring for goals of moderate or intensive LDL cholesterol
reduction, 6) thresholds for adding nonstatin LDL-lowering therapy in those at very
high risk or for heterozygous familial hypercholesterolemia and 7) cost value assessment
for expensive treatment.
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Suggested reading
- 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.J Am Coll Cardiol. 2018; (doi: 10.1016/j.jacc.2018.11.003. Also published in Circulation. 2018 Nov 10:CIR0000000000000624. doi: 10.1161/CIR.0000000000000624)
- The spectrum of type III hyperlipoproteinemia.J Clin Lipidol. 2018; 12: 1383-1389
- Induced cardiovascular procedural costs and resource consumption patterns after coronary artery calcium screening: results from the EISNER (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) study.J Am Coll Cardiol. 2009; 54: 1258-1267
- Use of Lipoprotein(a) in Clinical Practice: A Biomarker Whose Time Has Come. A Scientific Statement from the National Lipid Association.J Clin Lipidol. 2019; 13: 374-392
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease.J Am Coll Cardiol. 2019;
- PCSK9 Inhibitors: Economics and Policy.J Am Coll Cardiol. 2017; 70: 2677-2687
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© 2019 Published by Elsevier Inc. on behalf of National Lipid Association.
