KMID : 0882420190940050396
|
|
Korean Journal of Medicine 2019 Volume.94 No. 5 p.396 ~ p.402
|
|
Lipid-Lowering Therapy Guidelines
|
|
Lee Sang-Hak
|
|
Abstract
|
|
|
The major guidelines for lipid-lowering therapy (LLT) have been revised recently. Although ¡°higher cardiovascular risk-aggressive LLT with greater absolute clinical benefit¡± is the main idea underlying all guidelines, there are some differences in the details among them. The US guidelines recommend pharmacological LLT based on a patient¡¯s risk category, independently of their low-density lipoprotein-cholesterol (LDL-C) level. However, the European and Korean guidelines consider the patient¡¯s risk category and LDL-C at the same time. Lifestyle modifications are suggested in parallel in all guidelines. The newest US guidelines have characteristically revived target LDL-C values in some patient groups and indications for non-statin drugs (ezetimibe and PCSK9 inhibitors), whereas the European and Korean guidelines have maintained target LDL-C values as usual. It is universally accepted that statins are the first-line agent. Adding ezetimibe, bile acid sequestrants, or PCSK9 inhibitors is recommended as a second line treatment. Appreciating the trend and background of the newest LLT guidelines will be essential to maximize cardiovascular prevention in patients.
|
|
KEYWORD
|
|
Cholesterol, Atherosclerosis, Therapeutics, Lipoproteins
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|