The American Heart Association has released new cholesterol guidelines in unison with the American College of Cardiology. The premise behind these new guidelines is to understand and analyze the personal risk of cardiovascular disease (CVD) along with relevant treatment options. These guidelines are now set as the standard by more than ten well-established medical organizations. Through these guidelines, it will become easier to tailor recommendations and/or treatment plans using risk assessment processes. These treatments will encompass a variety of solutions, including statin/non-statin drug therapies.
A person that has been diagnosed with high cholesterol regardless of age can end up having a heightened risk profile for cardiovascular disease. Due to this high cholesterol, the blood vessels start to constrict because of the newly formed plaque. Based on this premise, the AHC guideline panel has taken the time to highlight what’s required during the decision-making process between healthcare professionals and their patients. These guidelines have been updated for the first time since 2013 with a greater assessment of lifetime risks for cardiovascular disease in combination with treatment options for lowering cholesterol levels.
Medical concerns involving heart disease, strokes, and heart attacks continue to plague Americans across the nation. Studies show over 836,000 people pass away in the U.S. due to this disease, with the number being greater than cancer-related or lung disease-related deaths. Along with these numbers, 360,000 people pass away due to coronary heart disease and 114,000 from heart attacks. It’s also important to note the presence of reoccurring heart attacks in America, which account for 335,000 cases in America per year.
These AHA guidelines will include a standardized risk calculator to determine a person’s risk profile for a possible cardiovascular event (i.e., stroke, heart attack) within the next decade. This calculator includes pre-determined guidelines from 2013, such as smoking, diabetes, high blood pressure, and unhealthy lipid levels, while also account for additional factors such as aspirin therapy and/or statin treatment. This risk calculator is going to act as a standardized method to determine a person’s risk profile while also accumulating personalized data from previous health exams.
Healthcare professionals are also asked to highlight the following risk variables to their patients:
- Ancestry (Asian)
- Family History Concerning Early Heart Disease (i.e., Men Under the Age of 55 with CVD or Women Under the Age of 65 with CVD)
- Chronic Kidney Disease
- Metabolic Syndrome
- High Triglycerides (i.e. 175 mg/dL)
- Chronic Inflammatory Conditions (HIV, Psoriasis)
- Early Menopause and/or Pre-Eclampsia
- Chronically High Cholesterol Levels (160 mg/dL) or Non-High-Density Lipoprotein Cholesterol (190 mg/dL)
- Additional Testing for Assessing CVD Risk
- Apolipoprotein B (130 mg/dL)
- High-Sensitivity C-Reactive Protein (2.0 mg/dL or More)
- Ankle-Brachial Index (Over 0.9) (i.e., Comparison of Blood Pressure from the Arm and Blood Pressure at the Ankle)
It’s important to note; these AHA guidelines are aimed at helping to diagnose high LDL levels before providing appropriate lowering solutions. The goal is to help lower LDL levels to approximately 70 mg/dL or less for high-risk patients. This recommendation was removed during the 2013 guidelines but has found its way back in the recent update. The emphasis is on taking these new guidelines to pinpoint a specific coronary artery calcium score (via a cardiac CT scan) and coming up with an assessment for statin therapy in those with intermediate CVD risk.
These guidelines are all about shedding light on potential risk factors to patients with a greater likelihood of being diagnosed with cardiovascular disease. When those patients recognize these signs and start implementing precautionary measures, it becomes easier to alleviate the likelihood of heart disease or heart attack. These lifestyle changes, including implementing a healthier diet, not smoking, and/or following a regular exercise regimen.
Healthcare practitioners can use these guidelines as a risk assessment tool while maintaining communication with their patients. This leads to improved and personalized decision-making due to the guidelines. It’s essential to personalize the treatment plan based on a patient’s medical history, medications, and/or lifestyle.
Based on new-age research, statins continue to be the best way to help lower LDL levels and can be used in different forms depending on an individual’s medical requirements. There are additional non-statin drug therapies involving PCSK9 inhibitors and/or ezetimibe, which can be used for high-risk patients to lower their LDL levels.