Editorial
February 4, 2019
JAMA. 2019;321(8):749-750. doi:10.1001/jama.2019.0045
Elevated serum cholesterol is one of the world’s most common and modifiable risk factors for cardiovascular disease (CVD). In the 5 years since the release of the 2013 American Heart Association/American College of Cardiology (AHA/ACC) guideline for lipid management,1 there have been multiple advances in lipid biology, epidemiology, and therapeutic clinical trials. This wealth of new evidence led the AHA/ACC to release a major revision of the lipid practice recommendations in 2018.2 Overall, the new guidelines are more evidence based and personalized than in the past but also more complex. The full content of the new lipid guidelines is contained in a well/.../
Management of Blood Cholesterol
JAMA. 2019;321(8):800-801. doi:10.1001/jama.2019.0015
Summary of the Clinical Problem
Pharmacologically lowering low-density lipoprotein cholesterol (LDL-C) consistently reduces ASCVD events (myocardial infarction, stroke, and cardiovascular death), and the principle that lower LDL-C is better was reaffirmed by trials that added ezetimibe or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors to statin therapy.1,2 The 2013 guideline removed specific LDL-C treatment targets, but high-quality trials since offered the opportunity to reintroduce such goals based on risk gradations.
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