title: The new dyslipidemia guidelines: what is the debate?
abstract: Dyslipidemia is a major risk factor for the development of atherosclerotic disease. Therefore, lifestyle interventions and pharmacological approaches to decrease cholesterol are widely used in cardiovascular disease prevention. The introduction and widespread use of 3-hydroxy-3 methylglutaryl coenzyme A inhibitors (statins) for individuals at risk of atherosclerotic disease has been an important advance in cardiovascular care. There can be no doubt that better control of dyslipidemia, even in subjects whose low-density lipoprotein cholesterol level is not particularly high, has reduced overall event rates. On a background of lifestyle interventions, statins are routinely used to decrease risk along with aspirin and interventions to control hypertension and diabetes. More than other risk factors, the approach to the identification and treatment of dyslipidemia has been heterogeneous and widely debated. The recent release of the 2013 American College of Cardiology/American Heart Association dyslipidemia guidelines has reignited the controversy over the best approach for risk stratification and treatment. In this article we review the importance of statin therapy for global cardiovascular risk reduction, compare the Canadian Cardiovascular Society dyslipidemia guidelines with other standards, and discuss the points of debate. Despite the seeming variety of recommendations, their common link is a systematic approach to risk stratification and treatment, which will continue to benefit our patients at risk.
authors: Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: todd.anderson@albertahealthservices.ca.
authors: Todd J
authors: TJ
authors: Anderson
authors: University of British Columbia, Vancouver, British Columbia, Canada.
authors: G B John
authors: GB
authors: Mancini
authors: McGill University Health Centre, Montreal, Québec, Canada.
authors: Jacques
authors: J
authors: Genest
authors: Institut de Cardiologie de Montréal, Université de Montréal, Montreal, Québec, Canada.
authors: Jean
authors: J
authors: Grégoire
authors: Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
authors: Eva M
authors: EM
authors: Lonn
authors: Robarts Research Institute, Western University, London, Ontario, Canada.
authors: Robert A
authors: RA
authors: Hegele
mesh_terms: D002170:Canada; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000187:drug effects; D050171:Dyslipidemias / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D012955:Societies, Medical; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors