4
Key Points
Î An elevated level of cholesterol carried by circulating apolipoprotein
(apo) B containing lipoproteins (non-high-density lipoprotein
cholesterol [non-HDL-C] and low-density lipoprotein cholesterol
[LDL-C], termed atherogenic cholesterol) is a root cause of
atherosclerosis, the key underlying process contributing to most
clinical atherosclerotic cardiovascular disease (ASCVD) events.
Î Reducing elevated levels of atherogenic cholesterol will lower
ASCVD risk in proportion to the extent that atherogenic cholesterol is
reduced.
Î The intensity of risk-reduction therapy should generally be adjusted to
the patient's absolute risk for an ASCVD event (see Table 1).
Î Atherosclerosis is a process that often begins early in life and
progresses for decades before resulting in a clinical ASCVD event.
Therefore, both intermediate-term and long-term/lifetime risk should
be considered when assessing the potential benefits and hazards of
risk-reduction therapies.
Î For patients in whom lipid-lowering drug therapy is indicated, statin
treatment is the primary modality for reducing ASCVD risk.
Î Treatment goals and periodic monitoring of atherogenic
cholesterol levels (non-HDLC and LDL-C) are important tools in the
implementation of a successful treatment strategy. These aid the
clinician in assessing the adequacy of treatment and facilitate active
participation by the patient through feedback and reinforcement of the
beneficial effects of lifestyle and pharmaceutical therapies.
Î Non-lipid ASCVD risk factors should also be managed appropriately,
particularly high blood pressure, cigarette smoking, and diabetes
mellitus.
Î NLA Dyslipidemia – Part II represents a continuation of NLA
Dyslipidemia – Part I
a
providing patient-centered, evidence-graded
recommendations for the management of specific aspects of
dyslipidemia.
a
Jacobson TA, Ito MK, Maki KC, et al. National Lipid Association Recommendations for
Patient-Centered Management of Dyslipidemia: Part 1. Lipid 2014; 8:473–88.
