Statins are widely used to lower blood cholesterol levels but not everyone can take these medicines because of accompanying side effects. A team of experts issued the use of non-statin therapies to lower cholesterol in patients considered as high-risk.
Presented at the American College of Cardiology (ACC) in Chicago, experts in the field of cardiology issued an expert consensus guidance regarding the use of non-statin therapies to reduce cholesterol levels in the blood. The document aims to provide practical guidance for doctors and patients during situations not covered by the 2013 ACC and American Heart Association guidelines.
The new document, published in the Journal of the American College of Cardiology, was titled, "2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk."
The authors from Northwestern University in Chicago reviewed evidence and provided guidance in one of the four statin benefit patient groups that were identified in the previous guidelines in 2013. They recommend that physicians explore non-statin type of therapies first like lifestyle factors such as smoking, exercise and diet, and then followed by the prescription of statins.
"This consensus pathway document is the first in a new format, where we offer guidance to clinicians in an easy to understand algorithm approach framed in a data supported fashion," said Dr. James Januzzi Jr., chair of the ACC's Task Force on Clinical Expert Consensus Documents.
Lifestyle modification is still a vital component in lowering cholesterol levels especially for patients who are at high risk of developing cardiovascular disease. The researchers recommend that doctors take into consideration other factors that could help lower these levels.
Some factors include adherence to a healthy lifestyle, control of other risk factors such as tobacco use, lack of physical activity and unhealthy diets.
The 2013 guidance included four major statin benefit groups, which include patients who are 21 years and older with Atherosclerotic Cardiovascular Disease (ASCVD), adults with low density lipoprotein (LDL) more than 190 mg/dl, adults who are between 40 years and 75 years old without ASCVD but with diabetes and LDL of 70 to 189 mg/dl and adults of the same age group without ASCVD or diabetes but with LDL between 70 and 189 mg/dl.
In the current guidance, experts take into account factors wherein other non-statin therapies may be given, and situations in which alternative therapies may be considered for patients.
"Before initiation of combination therapy, it is imperative for clinicians and patients to engage in a discussion that includes the potential for net," Dr. Donald M. Lloyd-Jones from Northwestern University in Chicago said in a statement.
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