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Published on: November 10, 2017
[Atherogenic dyslipidemia: a multidisciplinary consensus panel]
Insights
Atherogenic dyslipidaemia, marked by high triglycerides or low HDL-cholesterol, is under-recognized. Experts reached consensus on its diagnosis and treatment, though some aspects remain debated.
Area of Science:
- Cardiology
- Metabolic Disorders
- Public Health
Context:
- Dyslipidaemias remain under-diagnosed, under-treated, and poorly controlled globally.
- Existing data often focuses on hypercholesterolaemia or non-LDL dyslipidaemias in statin-treated patients.
- Limited information is available on atherogenic dyslipidaemia (high triglycerides and/or low HDL-cholesterol).
Purpose:
- To assess expert consensus on the definition, diagnosis, and treatment of atherogenic dyslipidaemia using the Delphi method.
- To identify areas of agreement and controversy among specialists from various scientific societies.
- To improve the effective management of this specific lipid anomaly.
Summary:
- Experts achieved significant agreement on epidemiological aspects, cardiovascular risk association, clinical identification, and specific treatments for atherogenic dyslipidaemia.
- Areas of ongoing controversy include the role of isolated hypertriglyceridaemia as a risk factor and therapeutic target.
- Debate persists regarding HDL-cholesterol's role in cholesterol efflux, individualized therapeutic goals, and the frequent need for combination therapy.
Impact:
- Highlights consensus on key aspects of atherogenic dyslipidaemia management.
- Identifies critical areas requiring further research and clinical discussion.
- Aims to enhance the control of dyslipidaemia and reduce associated cardiovascular risks.
Abstract:
The dyslipidaemias are conditions that are still under-diagnosed, under-treated, and poorly controlled. This condition is common to the rest of the risk factors considered fundamental. Within the dyslipidaemias, the data that we have available, generally refer to the hypercholesterolaemias or in particular to the dyslipidaemias not dependent on LDL in patients who are already being treated with statins. However, there is only limited data available on atherogenic dyslipidaemia, characterised by the elevation of triglycerides and/or a decrease in HDL-cholesterol. However, given its profile, to determine the particularities of this atherogenic dyslipidaemia could help to control this anomaly more effectively. The present study, conducted in accordance with the Delphi method, has as its purpose to demonstrate the level of agreement or disagreement of an expert group, made up from different scientific societies, on what atherogenic dyslipidaemia is and represents, as well as what is the most suitable diagnostic and therapeutic approach. It has been concluded that the level of knowledge of the epidemiological aspects, its association with cardiovascular risks, of clinical identification, and specific treatment, has reached a significant level of agreement between the experts consulted. However, some aspects have been detected that, even today, are still subject to controversy: the role of isolated hypertriglyceridaemia as a risk factor, and its consideration as a therapeutic objective both in primary and secondary prevention, the effects linked to HDL-cholesterol, and that are strictly associated with the capacity to produce cholesterol efflux, the appropriateness of the therapeutic objectives to individual particularities, as well as the need to employ - frequently - combined treatment to correctly approach the correction of the lipid profile as a whole.
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