The American Heart Association released new Cholesterol guidelines over the weekend that Mayo Clinic cardiologists believe will help doctors prescribe medication to patients more efficiently, with a risk assessment personalized for each patient.
The guidelines include treatment for people at high risk and offer a personalized risk assessment. The recommendations also encourage health care providers to assess whether a new drug is having the desired effect, within 12 weeks.
“I believe they represent significant positive steps in the way we treat cholesterol and the way we need to assess patients’ cardiovascular risk,” said Dr. Francisco Lopez-Jimenez.
Dr. Amy Pollak said she’s excited about the new guidelines because a lot has happened since 2013 and they integrate all that has been learned in the past five years and, “The revised guidelines do a beautiful job of integrating the data that’s come out over the last five years,” said Dr. Pollak.
“This has been much anticipated, and I think it will be a very useful tool for health care providers and patients as we talk about the right cholesterol level for a given patient, what the future risk of heart disease might be for that patient, and is there a role for medications,” she added.
Highlights from the new statement:
- High cholesterol, at any age, can increase a person’s lifetime risk for heart disease and stroke. A healthy lifestyle is the first step in prevention and treatment to lower that risk.
- The 2018 guidelines recommend more detailed risk assessments to help health care providers better determine a person’s individualized risk and treatment options.
- In some cases, a coronary artery calcium score can help determine a person’s need for cholesterol-lowering treatment, if their risk status is uncertain or if the treatment decision isn’t clear.
- While statins are still the first choice of medication for lowering cholesterol, new drug options are available for people who have already had a heart attack or stroke and are at highest risk of having another. For those people, medication should be prescribed in a stepped approach, first with a maximum intensity statin treatment, adding ezetimibe if desired LDL cholesterol levels aren’t met and then adding a PCSK9 inhibitor if further cholesterol reduction is needed.