What are the guidelines for the treatment of hyperlipidemia?
Apr 27, 2022 · Increased viscous (soluble) fiber (10-25 g/day) and plant stanols/sterols (2 g/day) to enhance LDL lowering. Weight management; and. Increased physical activity. The patient described here has ...
When to consider treatment for hypertension (high blood pressure)?
Jul 01, 2019 · Statin is the first line drug for hypercholesterolemia and the dosage is recommended to be adjusted to reach the target LDL-C level. The primary treatment goal is to lower the LDL-C to the target level or below and the secondary goal is to lower non-HDL-C concentration to target or below.
What is the primary goal of dyslipidemia treatment?
Mar 01, 2022 · According to the 2000 American Diabetes Association Guidelines, the primary goal of hyperlipidemia therapy in patients with type 2 diabetes (with or …
What are the new guidelines for the management of hypercholesterolemia?
Hyperlipidemia Protocol – Stanford Coordinated Care Page 4 B. ASSESSMENT 1. Subjective a. Review contraindications for treatment, patient’s medical history, drug history, and drug interactions. b. Review medication list (including Rx, OTC, and herbal supplements) and dietary compliance and adherence.
What is the treatment goals in the management of hyperlipidemia?
What is the treatment goal for hypertension?
What is the goal of cholesterol management?
What is first line treatment for hyperlipidemia?
What is the goal blood pressure for patients with hypertension according to the ACC AHA guidelines?
What are the current guidelines for diagnosing and treating hypertension?
What is the optimal goal for LDL cholesterol?
What is the primary target of treatment in lipid management?
When do you treat LDL cholesterol?
What are the new guidelines for statins?
- Patients ages 20-75 years and LDL-C ≥190 mg/dl, use high-intensity statin without risk assessment.
- T2DM and age 40-75 years, use moderate-intensity statin and risk estimate to consider high-intensity statins.
What is the best treatment for high cholesterol?
- Reduce saturated fats. Saturated fats, found primarily in red meat and full-fat dairy products, raise your total cholesterol. ...
- Eliminate trans fats. ...
- Eat foods rich in omega-3 fatty acids. ...
- Increase soluble fiber. ...
- Add whey protein.
What are the new guidelines for cholesterol levels?
Question
I have a patient who has been taking hypertension medication for the past 3 years. His most recent lipid profile was: triglycerides 300 mg/dL, low-density lipoprotein-cholesterol (LDL-C) 140 mg/dL, high-density lipoprotein-cholesterol (HDL-C) 30 mg/dL.
Response From the Expert
Karen B. Shapiro, PharmD, BCPS#N#Clinical Pharmacist, Arcadian Health Plan, San Dimas, California
How much HDL cholesterol is needed for ATP III?
The ATP III guidelines have been expanded to recognize the importance of HDL levels by raising the threshold of low HDL cholesterol from less than 35 mg per dL (0.90 mmol per L) to less than 40 mg per dL (1.05 mmol per L). [Evidence level C, consensus/expert opinion]
What are the risk factors for CHD?
Other risk factors such as cigarette smoking, hypertension, diabetes, and a low level of high-density lipoprotein (HDL) cholesterol also have been implicated in CHD. 3. In an effort to address this public health issue, the National Institutes of Health established the National Cholesterol Education Program in 1985.
What is considered a CHD?
Patients with diabetes and those with a 10-year cardiac event risk of 20 percent or greater are considered CHD equivalents. Once low-density lipoprotein cholesterol is at an accepted level, physicians are advised to address the metabolic syndrome and hypertriglyceridemia.
Is diabetes a CHD?
The establishment of diabetes as a CHD risk equivalent reflects the prevalence of heart disease as a cause of death in the diabetic population. Three fourths of patients with diabetes die from heart disease–related illnesses compared with one half of the general population.
What is metabolic syndrome?
Metabolic syndrome, or insulin resistance syndrome, is defined as a cluster of abnormalities that include obesity, hypertension, dyslipidemia, and type 2 diabetes; it is associated with insulin resistance and compensatory hyperinsulinemia. 18 It is estimated that this syndrome affects 70 to 80 million Americans. 19.
What is the ATP III?
The ATP III recognizes the increasing number of studies correlating elevated triglyceride levels with increased coronary artery disease risk. By lowering the acceptable triglyceride level from the previous set of guidelines, the ATP III encourages a more aggressive approach to hypertriglyceridemia ( Table 7). 4 Diet and exercise are the primary modes of treating hypertriglyceridemia. If indicated, nicotinic acid and fibric acid derivatives are the most efficacious in lowering triglyceride levels. Triglyceride reduction is a secondary benefit of statins (the primary benefit being LDL cholesterol reduction).
What is FRS in NCEP?
The FRS is a risk assessment tool that has been derived from data collected in the Framingham Heart Study. 11 As mentioned previously, the new NCEP guidelines recommend that patients with two or more risk factors have their FRS calculated. [Evidence level B, retrospective data analysis]
What is the best treatment for myocardial infarction?
Omega-3 fatty acids may be a good alternative after myocardial infarction for patients who cannot tolerate statins. Fibrates and niacin have not been shown to reduce all-cause mortality in secondary prevention, but may be useful adjuncts when statins alone cannot adequately control lipid levels.
When should statins be used?
Statin therapy should be used in the primary prevention of cardiovascular events in high-risk patients. Statin therapy should be initiated in patients with a history of cardiovascular disease or the risk equivalent. High-dose statin therapy should be initiated in patients with acute coronary syndrome.
Does statin therapy reduce mortality?
A Cochrane review concluded that statin use did not reduce mortality in patients with peripheral arterial disease. 50 However, using statins in these patients increased maximal walking distance by 499 ft (152 m) and pain-free walking distance by 295 ft (90 m). Lipid therapy did not change ankle-brachial index scores. Statin therapy for patients with abdominal aortic aneurysms has not been shown to change the rate of expansion, but patients who are taking statins at the time of a rupture have a lower mortality rate (NNT = 3.5). 51, 52
How far can you walk with statins?
50 However, using statins in these patients increased maximal walking distance by 499 ft (152 m) and pain-free walking distance by 295 ft (90 m).
Does statin help with stroke?
A Cochrane review of statins for secondary prevention of cerebrovascular disease reported that statins reduced recurrent strokes (NNT = 76), but not all-cause mortality. 47 Other lipid-lowering medications, including fibrates, increased the risk of subsequent strokes. In an acute setting, initiating statin therapy may reduce stroke severity and disability, with data supporting 40 to 80 mg of atorvastatin daily over 20 to 80 mg of simvastatin daily. 48 However, initiating high-dose atorvastatin after ischemic stroke has been shown to increase the risk of hemorrhagic stroke (NNH = 106 over five years of treatment), while reducing recurrent ischemic strokes (NNT = 42 over five years of treatment) and not affecting overall mortality. 49 Thus, initiating a moderate-dose statin is an option to reduce the risk of recurrent strokes.
How to lower cholesterol?
To be smarter about what you eat, pay more attention to food labels. As a starting point: 1 Know your fats. Knowing which fats raise LDL cholesterol and which ones don’t is key to lowering your risk of heart disease. 2 Cook for lower cholesterol. A heart-healthy eating plan can help you manage your blood cholesterol level.
How old do you have to be to have your cholesterol checked?
If you’re 20 years or older, have your cholesterol tested and work with your doctor to adjust your cholesterol levels as needed. Often, changing behaviors can help bring your numbers into line. If lifestyle changes alone don’t improve your cholesterol levels, medication may be prescribed. Lifestyle changes include:
What does it mean when you have too much cholesterol?
One type of hyperlipidemia, hypercholesterolemia, means you have too much non-HDL cholesterol and LDL (bad) cholesterol in your blood. This condition increases fatty deposits in arteries and the risk of blockages.
Does smoking lower cholesterol?
Smoking also compounds the risk from other risk factors for heart disease, such as high blood pressure and diabetes. By quitting, smokers can lower their LDL cholesterol and increase their HDL cholesterol levels. It can also help protect their arteries. Nonsmokers should avoid exposure to secondhand smoke.
What is a dash diet?
Many diets fit this general description. For example, the DASH (Dietary Approaches to Stop Hypertension) eating plan promoted by the National Heart, Lung, and Blood Institute as well as diets suggested by the U.S. Department of Agriculture and the American Heart Association are heart-healthy approaches.