Reducing CVD risk - integration of clinical and laboratory criteria.
BACKGROUND
Recent updates to National Heart Foundation of Australia (NHFA) Lipid management guidelines and Pharmaceutical Benefits Scheme (PBS) criteria for subsidised lipid lowering therapy have resulted in greater alignment between the two documents. However, several recommendations, such as the need to focus on low density lipoprotein cholesterol level rather than total cholesterol, while well supported in the literature, may initially create confusion for both patients and clinicians.


OBJECTIVE
This article summarises the likely pathology reporting changes that will occur as a result of a recent review of NHFA guidelines by the Australian Pathology Lipid Interest Group; compares current PBS criteria for subsidised lipid lowering therapy to the NHFA high risk categories and treatment targets; and provides an algorithm for treatment based on the PBS criteria integrating risk factors and lipid levels.


CONCLUSIONS
Although pathology testing plays an important role in the assessment of risk in patients, it is ultimately the clinician who must determine the patient's absolute risk based on all relevant previous and current clinical information before the initiation or review of appropriate treatment.
Aesir Medical Research, Victoria, Australia.
David P
DP
Tognarini
David R
DR
Sullivan
David W
DW
Thomas
Ken
K
Sikaris
D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D008019:Life Style; D010347:Patient Care Planning; D017410:Practice Guidelines as Topic; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors
D015415:Biomarkers; D000960:Hypolipidemic Agents; D002784:Cholesterol