ACC, AHA Release 2018 Guideline on the Management of Blood Cholesterol at AHA Scientific Sessions
Nov. 10, 2018
NLA among 12 organizations to co-author, endorse key document for reducing risk of atherosclerotic cardiovascular disease
CHICAGO — The American College of Cardiology and American Heart Association, in collaboration with the National Lipid Association and nine other specialty societies, today released the 2018 Guideline on the Management of Blood Cholesterol at AHA Scientific Sessions in Chicago.
The document, an update to the 2013 Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, emphasizes the importance of a heart-healthy lifestyle for all individuals and provides updated guidance for treatment of patients with atherosclerotic cardiovascular disease (ASCVD) risk, severe primary hypercholesterolemia and diabetes mellitus.
Carl E. Orringer, MD, FACC, FNLA, an associate professor of medicine at the University of Miami’s Miller School of Medicine and NLA past president, represented the NLA as a co-author. Joseph J. Saseen, PharmD, FAHA, FNLA, secretary/treasurer of the NLA, also served as a co-author and represented the American Pharmacists Association. He is a professor and vice chair of the department of clinical pharmacy and family medicine at the University of Colorado Denver. Lynne Braun, PhD, CNP, FAHA, FNLA, was a co-author and served as the representative for the Preventive Cardiovascular Nurses Association.
“The National Lipid Association is proud to unanimously endorse the 2018 Guideline on the Management of Blood Cholesterol,” said NLA President Alan S. Brown, MD, FACC, FAHA, FNLA. “As a preeminent leader in lipidology, it was important the NLA was represented in the writing of this guideline. We are proud of Dr. Orringer and Dr. Saseen for their great work on this document and would like to thank the American College of Cardiology and American Heart Association for calling on our expertise to serve on the writing committee and as an endorsing partner. The NLA looks forward to future collaborations with the ACC, AHA and other endorsing organizations from this document.”
“I was greatly honored to serve as the National Lipid Association representative to the 2018 Guideline on the Management of Blood Cholesterol,” said Dr. Orringer. “This guideline is a rigorously developed, evidence-based document that covers a broad array of topics that impact the daily practice of clinical lipidology. Its implementation will require an informed practitioner who engages in a carefully considered clinician-patient discussion. The National Lipid Association is properly positioned to educate practitioners on the content and application of our guideline. We all look forward to a great year ahead as we begin the educational process.”
Several of the updates in the document include elements of previously published NLA positions on the need for more precise patient-oriented risk assessment and intensive treatment recommendations. Among those updates are the recommendation to begin high-intensity statin therapy in patients with severe hypercholesterolemia without ASCVD risk calculation, which includes young familial hypercholesterolemia (FH) patients. It also discusses when to consider add-on non-statin therapy for FH.
Another previously published NLA position included in the document is guidance on when to use add-on non-statin therapy in high risk ASCVD patients. The document also mentioned risk-enhancing factors as considerations for statin therapy, a concept published in the NLA’s Recommendations for Patient-Centered Management of Dyslipidemia in 2014. Additional document updates in line with previous NLA positions include diabetic patients without ASCVD not requiring risk calculation in order to receive statin therapy, considering coronary artery calcium testing to facilitate provider-patient discussion about statin initiation and continuous monitoring of lipid levels to assess efficacy and adherence of therapy.
The official document, co-published in the Journal of the American College of Cardiology and Circulation, can be accessed here.
Other organizations that co-authored and endorsed the document were the American Association of Cardiovascular and Pulmonary Rehabilitation, American Academy of Physician Assistants, Association of Black Cardiologists, American College of Preventive Medicine, American Diabetes Association, American Geriatrics Society, American Society for Preventive Cardiology and Preventive Cardiovascular Nurses Association.