LDL-C: Lower is Better for Longer - Even at Low Risk

Penson, P, Pirro, M and Banach, M (2020) LDL-C: Lower is Better for Longer - Even at Low Risk. BMC Medicine, 18. ISSN 1741-7015

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Abstract

Background: Low-density lipoprotein cholesterol (LDL-C) causes atherosclerotic disease, as demonstrated in experimental and epidemiological cohorts, randomised controlled trials, and Mendelian randomisation studies.
Main text: There is considerable inconsistency between existing guidelines as to how to effectively manage patients at low overall risk of cardiovascular disease (CVD) who have persistently elevated levels of LDL-C.
We propose a step-by-step practical approach for the management of cardiovascular risks in individuals with low (< 1%) 10-year risk of CVD, and elevated (> 140 mg/dL, 3.6 mmol/L) LDL-C. The strategy proposed is based on the level of adherence to lifestyle interventions (LSI), and in case of non-adherence, stepwise practical management, including lipid-lowering therapy, is recommended to achieve a target LDL-C levels (< 115 mg/dL, 3.0 mmol/L).
Conclusions: Further studies are necessary to answer the questions on the long-term efficacy, safety, and cost-effectiveness of the suggested approach. This is critical, considering the ever-increasing numbers of such low-risk patients seen in clinical practice.

Item Type:	Article
Uncontrolled Keywords:	11 Medical and Health Sciences
Subjects:	R Medicine > R Medicine (General) R Medicine > RM Therapeutics. Pharmacology
Divisions:	Pharmacy and Biomolecular Sciences
Publisher:	BioMed Central
Date of acceptance:	23 September 2020
Date of first compliant Open Access:	12 October 2020
Date Deposited:	12 Oct 2020 11:14
Last Modified:	04 Sep 2021 06:32
DOI or ID number:	10.1186/s12916-020-01792-7
URI:	https://researchonline.ljmu.ac.uk/id/eprint/13823

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