Patients at the Heart of New Cholesterol Guidelines

The European Society of Cardiology has released new guidelines recommending that patients lower their LDL cholesterol to reduce their risk of cardiovascular disease.  But the guidelines don’t just reinforce an important truth. They make it actionable for patients.  

The guideline’s authors developed them in a way that facilitates “informed communication” about cardiovascular disease risks.  Authors also focused on how to adopt and sustain lifestyle modifications and the benefits of addressing high LDL cholesterol early.  Facilitating communication about these important topics between patients and their health care providers is a timely consideration.  

“There is now overwhelming evidence from experimental, epidemiological, genetic studies, and randomised clinical trials, that higher LDL cholesterol is a potent cause of heart attack and stroke,” explained Professor Colin Baigent, chairperson of the guidelines task force.

Even though heart disease deaths are decreasing, they remain the leading cause of mortality across Europe.  Cardiovascular disease is largely preventable; nevertheless, it claims nearly 4 million lives a year. Along with smoking and alcohol consumption, high blood cholesterol rounds out the top three risk factors.  

A press release about the recommendations highlights the importance of effective medication use to achieve LDL targets.  Depending on a patient’s individual characteristics and risks, a doctor may prescribe one or more common medications: statins, ezetimibe or PCSK9 inhibitors.  Most patients effectively lower their “bad” LDL levels using statins and lifestyle modifications.  

Yet statins aren’t recommended for all patients.  Pre-menopausal women, for example, shouldn’t take them.  And statins alone don’t lower some patients’ LDL cholesterol enough.  One subset of patients, those with familial hypercholesterolemia, may need PCSK9 inhibitors instead of, or in addition to, statin therapy, though insurance barriers have derailed access across the U.S.  Health care policies have also made getting the innovative medication difficult in certain European countries.

Curtailing cardiovascular disease morbidity and mortality has the potential to save lives, restore livelihoods and save economies countless euros.  With the help of these guidelines, physicians and patients can work together to make these goals a reality.

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