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Closing the gap between guidelines and clinical practice for managing dyslipidemia: where are we now?
Sheth, Sohum; Banach, Maciej; Toth, Peter P.
Afiliación
  • Sheth S; University of Florida College of Medicine, Gainesville, FL, USA.
  • Banach M; Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Lodz, Poland.
  • Toth PP; Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Expert Rev Cardiovasc Ther ; : 1-17, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-39198976
ABSTRACT

INTRODUCTION:

Despite decades of research clearly illustrating the direct link between low-density lipoprotein cholesterol (LDL-C) and atherosclerotic cardiovascular disease (ASCVD) risk, LDL-C goal attainment rates are remarkably low in both the primary and secondary prevention settings. AREAS COVERED Herein we detail (1) the low rates of LDL-C goal attainment; (2) despite guidelines clearly outlining indications of use, there is suboptimal initiation, intensification, and persistence of lipid lowering therapy, especially combination therapy; (3) key clinician-related factors contributing to this gap include inconsistent risk assessments, clinical inertia, and barriers to health access; (4) LDL-C reduction is associated with reductions in risk for cardiovascular events. Increasing LDL-C goal attainment rates should be a high public health priority. EXPERT OPINION There is an urgent need to rethink dyslipidemia management. Opportunities exist to overcome LDL-C goal attainment barriers, which necessitates a concerted effort from patients, clinicians, health systems, payors, pharmaceutical companies, and public health advocates. LDL-C measurement should be a performance metric for health systems. In addition, upfront use of combination therapy and polypill formulations should be encouraged. Engaging pharmacists to support drug therapy and adherence is crucial. Leveraging telehealth and electronic medical record (EMR) functionalities can enhance these efforts and ensure more effective implementation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Expert Rev Cardiovasc Ther Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Expert Rev Cardiovasc Ther Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido