title: [Consensus on objectives and action guidelines on low density lipoproteins-cholesterol control in very high risk cardiovascular patients].
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of death in developed countries. Among cardiovascular disease risk factors one of the most relevant is low-density lipoprotein-associated cholesterol (LDL-c), but there is controversy about the methods used to control it. The aim was to obtain an expert opinion to clarify the most relevant issues regarding the control of dyslipidemia in very high cardiovascular risk patients.
  
  
  METHODS
  A survey with 55 items, stratified into 4 blocks: LDL-c as a therapeutic target, therapeutic goals, causes of the failure to achieve LDL-c goals, and recommendations to optimize their achievement, was addressed to 41 specialists (Cardiology and Internal Medicine) using the Delphi method to achieve professional consensus criteria.
  
  
  RESULTS
  A high consensus was reached among all items, in line with the European recommendations. The panelists considered that the goal of 70mg/dl for LDL-c for high cardiovascular disease risk (mainly vascular disease, diabetes mellitus, and renal failure), using combined treatment when necessary. Lack of adherence and therapeutic inertia were considered the main reasons for treatment failure.
  
  
  CONCLUSIONS
  The Spanish experts show an elevated consensus with the European recommendations, confirming the LDL-c control target of <70mg/dl. The simplification of the guidelines and the combined treatment may favor an improvement the achievement of lipid target goals.
authors.affiliation: Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, España; Sección de Riesgo Vascular y Rehabilitación, Sociedad Española de Cardiología, España. Electronic address: egalve@vhebron.net.
authors.forename: Enrique
authors.initials: E
authors.lastname: Galve
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España; Grupo de Trabajo de la Sociedad Española de Arteriosclerosis, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Guijarro-Herraiz
authors.affiliation: Unitat de Medicina Vascular i Metabolisme, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, IISPV, CIBERDEM, Reus, Tarragona, España; Grupo de Trabajo de la Sociedad Española de Arteriosclerosis, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Masana-Marin
authors.affiliation: Sección de Riesgo Vascular y Rehabilitación, Sociedad Española de Cardiología, España; Hospital Universitario San Juan de Alicante, Alicante, España.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cordero-Fort
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood*; D032921:Consensus; D003697:Delphi Technique; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D055118:Medication Adherence; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013030:Spain; D011795:Surveys and Questionnaires
chemical_list: D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL
keywords: Colesterol asociado a lipoproteínas de baja densidad; Criterio profesional; Delphi method; Highest cardiovascular risk; Low-density lipoprotein-associated cholesterol; Muy alto riesgo cardiovascular; Método Delphi; Professional criteria