On Nov. 10, the American College of Cardiology and the American Heart Association released updated cholesterol guidelines.
The new guidelines, which were published in the Journal of the American College of Cardiology, expand on the 2013 guidelines by adding to the list of cholesterol risk factors as well as suggesting new drug treatment options.
New cholesterol risk factors include family history and ethnicity; along with metabolic syndrome, chronic kidney disease, and chronic inflammatory conditions. These new factors add to a list that includes smoking, high blood pressure, and high blood sugar — and are intended to help doctors make more detailed risk assessments for patients.
New drug options suggested by the guidelines include ezetimibe, which helps lower cholesterol levels in the liver and gastrointestinal tract, and PCSK9 inhibitors, which help the liver break down cholesterol. Both of these medicines can be expensive, however. Statins, the traditional pills used to treat high cholesterol, are still recommended and can be coupled with the newer drugs for high-risk patients.
The new guidelines also provide dietary suggestions to help prevent high cholesterol. They recommend eating a more balanced diet that is higher in fruits, vegetables, whole grains, and low-fat protein sources. For adults, the guidelines also recommend moderate to vigorous physical activity three-to-four times per week and about forty minutes per session.
According to the Centers for Disease Control (CDC), more than 102 million Americans above 20 years old have high cholesterol. Dr. Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic, views the new guidelines as an improvement. “It’s much more in line with what a lot of us think should have been done in 2013,” he said.
The guidelines’ authors hope that adding more risk factors and drug options will help healthcare providers more accurately determine individuals’ risks and provide a more effective, personalized service.
“High cholesterol treatment is not one size fits all, and this guideline strongly establishes the importance of personalized care,” said ACC President Michael Valentine. “Over the past five years, we’ve learned even more about new treatment options and which patients may benefit from them. By providing a treatment roadmap for clinicians, we are giving them the tools to help their patients understand and manage their risk and live longer, healthier lives.”
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