Guideline shifts focus from emphasis on LDL cholesterol targets to individualized approach for lowering overall cardiovascular risk<\/p>\n<\/h3>\n
<\/b><\/p>\n
<\/b><\/p>\n
THURSDAY, May 5, 2022 (HealthDay News) — In a clinical practice guideline published online May 4 in The BMJ, <\/em>risk-stratified recommendations are presented for whether another lipid-lowering drug should be added among adults with low-density lipoprotein (LDL) cholesterol levels >1.8 mmol\/L (>70 mg\/dL) who are already taking the maximum dose of statins or who are intolerant to statins.<\/p>\n Qiukui Hao, M.D., from Sichuan University in Chengdu, China, and colleagues reviewed the evidence from 14 trials with 83,660 participants to explore whether another lipid-lowering drug should be added for adults with LDL cholesterol levels >70 mg\/dL who are already taking the maximum dose of statins or are intolerant to statins.<\/p>\n The recommendations provided by the panel were mostly weak, so shared decision-making with patients is advised when applying them. The panel states that for adults with LDL cholesterol >70 mg\/dL, on the maximum dose of statins or intolerant to statins, the addition of a lipid-lowering drug is not recommended for those who are at low cardiovascular risk. When considering the addition of a lipid-lowering drug for those on the maximum dose of statins or intolerant to statins who have a high or very high cardiovascular risk, ezetimibe is suggested in preference to a proprotein convertase subtilisin\/kexin 9 (PCSK9) inhibitor.<\/p>\n “Because of the anticipated large variability of patients’ values and preferences, well informed choices warrant shared decision making,” the authors write.<\/p>\n