Lipids and CVD management: towards a global consensus.
Cardiovascular disease (CVD) is currently the leading cause of morbidity and mortality worldwide and its incidence is likely to increase. Multiple risk factors contribute to CVD. Elevated LDL-cholesterol (LDL-C) and triglyceride levels, low HDL-cholesterol levels, hypertension, type 2 diabetes, and smoking are key modifiable risk factors. Such risk factors are present in 80-90% of coronary heart disease (CHD) patients. For many factors, modification can significantly reduce CVD incidence. For example, statin-induced LDL-C reductions reduce cardiovascular events by 24-37% and smoking cessation reduces CHD mortality by 36%. The need to identify and treat these risk factors has led many national and local groups to develop clinical practice guidelines for management of CVD. Although the aim of such guidelines is to provide practitioners with a framework to identify, prioritize, and manage patients, the plethora of guidelines can cause confusion. In addition, research indicates that guidelines are not being optimally implemented. This review considers these practical issues, highlights the common goals shared by many guidelines, and focuses on how these can be best achieved. It also highlights areas where the guidelines differ and discusses points to consider when selecting the most appropriate recommendation.
Arteriosclerosis and Lipoprotein Section, Baylor College of Medicine, Houston, TX, USA.
Christie
C
Ballantyne
Bruce
B
Arroll
James
J
Shepherd
D000465:Algorithms; D002318:Cardiovascular Diseases / Q000097:blood / Q000208:ethnology / Q000628:therapy*; D032921:Consensus; D003327:Coronary Disease / Q000097:blood / Q000208:ethnology / Q000517:prevention & control; D006292:Health Priorities; D006801:Humans; D006949:Hyperlipidemias / Q000517:prevention & control*; D008055:Lipids / Q000097:blood*; D008403:Mass Screening / Q000379:methods; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior
D008055:Lipids