[ESC guidelines on dyslipidemia update 2025 : New recommendations for the practice]

Area of Science:

• Cardiology
• Atherosclerosis
• Lipid Metabolism

Background:

• The European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) periodically update dyslipidemia guidelines.
• New evidence necessitates revisions to risk assessment and management strategies.

Purpose of the Study:

• To outline the key innovations and recommendations in the 2025 ESC/EAS guidelines on dyslipidemia.
• To highlight changes in risk stratification, risk modifiers, and treatment approaches.

Main Methods:

• Incorporation of updated evidence and risk assessment tools like SCORE2 and SCORE2-OP.
• Inclusion of novel risk modifiers: family history, ethnicity, comorbidities, hs-CRP, and Lp(a).
• Focus on specific patient subgroups, including those with acute coronary syndrome, HIV, and undergoing anthracycline treatment.

Main Results:

• Improved cardiovascular risk stratification, particularly in older individuals, using SCORE2 and SCORE2-OP.
• Introduction of risk modifiers to refine risk categories and guide treatment intensity.
• Emphasis on immediate high-intensity statin therapy, often with ezetimibe, for acute coronary syndrome.
• Specific recommendations for elevated lipoprotein(a) [Lp(a)] and high-risk subgroups like HIV patients and those on anthracyclines.
• Discouragement of dietary supplements and vitamins for primary prevention.

Conclusions:

• The 2025 guidelines reinforce risk-adapted low-density lipoprotein cholesterol (LDL-C) targets and stepwise treatment.
• Expanded treatment options and emphasis on early, consistent lipid-lowering are key.
• The update provides practical recommendations for managing dyslipidemia based on the latest scientific evidence.