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[Consensus on objectives and action guidelines on low density lipoproteins-cholesterol control in very high risk
Enrique Galve1, Carlos Guijarro-Herraiz2, Luis Masana-Marin3
1Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, España; Sección de Riesgo Vascular y Rehabilitación, Sociedad Española de Cardiología, España.
Insights
Spanish experts agree on targeting low-density lipoprotein cholesterol (LDL-c) below 70 mg/dl for very high cardiovascular risk patients. Simplifying guidelines and using combined treatments can improve achieving these lipid goals.
Area of Science:
- Cardiology
- Internal Medicine
- Lipidology
Background:
- Cardiovascular disease is a leading cause of death globally.
- Low-density lipoprotein cholesterol (LDL-c) is a key risk factor.
- Controversy exists regarding optimal LDL-c control methods.
Purpose of the Study:
- To gather expert opinion on dyslipidemia management in high-risk patients.
- To clarify key issues in controlling LDL-c.
- To establish professional consensus criteria using the Delphi method.
Main Methods:
- A 55-item survey was administered to 41 specialists.
- The survey covered LDL-c targets, goals, failure causes, and optimization.
- The Delphi method was employed to achieve consensus.
Main Results:
- High consensus was achieved, aligning with European recommendations.
- Experts supported an LDL-c goal of <70 mg/dl for high-risk individuals.
- Lack of adherence and therapeutic inertia were identified as primary reasons for treatment failure.
Conclusions:
- Spanish experts reached a strong consensus supporting European guidelines for LDL-c control (<70 mg/dl).
- Simplifying guidelines and utilizing combined therapies may enhance goal achievement.
- Optimizing lipid target achievement is crucial for managing high cardiovascular risk.
Introduction:
Cardiovascular disease is the leading cause of death in developed countries. Among cardiovascular disease risk factors one of the most relevant is low-density lipoprotein-associated cholesterol (LDL-c), but there is controversy about the methods used to control it. The aim was to obtain an expert opinion to clarify the most relevant issues regarding the control of dyslipidemia in very high cardiovascular risk patients.
Materials And Methods:
A survey with 55 items, stratified into 4 blocks: LDL-c as a therapeutic target, therapeutic goals, causes of the failure to achieve LDL-c goals, and recommendations to optimize their achievement, was addressed to 41 specialists (Cardiology and Internal Medicine) using the Delphi method to achieve professional consensus criteria.
Results:
A high consensus was reached among all items, in line with the European recommendations. The panelists considered that the goal of 70mg/dl for LDL-c for high cardiovascular disease risk (mainly vascular disease, diabetes mellitus, and renal failure), using combined treatment when necessary. Lack of adherence and therapeutic inertia were considered the main reasons for treatment failure.
Conclusion:
The Spanish experts show an elevated consensus with the European recommendations, confirming the LDL-c control target of <70mg/dl. The simplification of the guidelines and the combined treatment may favor an improvement the achievement of lipid target goals.
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