National Lipid Association Releases a Draft of Part Two of Its Recommendations for Patient-Centered Management of Dyslipidemia
Part Two Provides New Recommendations for Managing Cholesterol in Diverse and Underrepresented Ethnic and Racial Groups along with Recommendations that Cross the Life Span from Children to Seniors
CHICAGO — Today, the National Lipid Association (NLA) released a draft of its Part Two Recommendations based on a panel of independent experts.
Part Two of the NLA Recommendations highlights the importance of managing cholesterol levels in special populations, including diverse ethnic and racial groups such as African-Americans, Hispanics and South Asians, and conditions that span the life span from children to seniors, from pregnancy to menopause, and conditions not previously identified as being high-risk such as individuals with HIV or rheumatologic disease.
In addition, the Recommendations reinforce the importance of lifestyle changes as the cornerstone of therapy and provide new detailed advice for specific changes in diet, dietary patterns, and the amount of physical activity and exercise required for cardiovascular health.
Additional highlights from the Recommendations include these:
- After lifestyle therapy, statins remain the treatment of choice for people with high-risk conditions, including HIV and rheumatoid arthritis, and those at risk based on ethnicity or race, such as African-Americans and South Asians.
- Increased rates of obesity, metabolic syndrome and diabetes in ethnic and racial minorities is of great concern, and aggressive efforts in lifestyle control are needed to combat a growing public health problem.
- Atherosclerosis often begins early in life and progresses for decades, so reducing atherogenic cholesterol in younger individuals such as children and adolescents is important for long-term cardiovascular health.
- Given the importance of adherence to both lifestyle therapies and lipid-lowering drugs, the NLA advocates: 1) discussion of adherence at each patient visit to identify problems, barriers or side effects of therapy; 2) continuous feedback to patients about their LDL cholesterol levels and their LDL cholesterol goals; and 3) the use of an interdisciplinary team of health care providers—including nurses, nurse practitioners, clinical pharmacists, physician assistants and registered dietitian nutritionists—to assist patients with adherence issues.
- For high-risk patients not at their cholesterol goal while on a maximally tolerated statin dose, consideration should be given to adding non-statin lipid-altering therapies (e.g., ezetimibe) for further lowering of atherogenic cholesterol.
The NLA Recommendations are meant to serve as a guide for health care providers in the diagnosis and treatment of lipid disorders and are intended to provide additional expert guidance to currently available guidelines for the treatment of high blood cholesterol. The Recommendations are also intended to assist clinicians in patient management in areas that have not been addressed in previous guidelines. Slides of Part Two of the NLA Recommendations are available in draft form on the NLA website, with a two-week public comment period starting June 11. The final version of Part Two is scheduled to publish later in 2015 in the Journal of Clinical Lipidology (JCL) after the consideration of comments.
“The NLA Part Two Recommendations build on our previous NLA Part One Recommendations and will be open for a public comment period by interested stakeholders including members of the broader health care community and the general public. The NLA values stakeholder input in terms of suggestions, comments, concerns, differences in interpretation of scientific evidence, or different value sets,“ said Dr. Terry A. Jacobson, MD, president of the National Lipid Association and professor of medicine at Emory University in Atlanta. “We are excited to provide a comprehensive set of recommendations in the management of atherogenic cholesterol that may aid clinicians and patients in making better clinical decisions using a patient-centered approach.”
A tool for health care professionals, which can be downloaded on mobile devices, is currently available at https://www.lipid.org/. Additionally, in keeping with its tradition of providing useful tools for both health care providers and consumers, the NLA will develop educational materials for each section of the Recommendations. These will be made available on the NLA website in the coming month.
For more information and tools related to the NLA Recommendations, visit lipid.org/recommendations.
About the National Lipid Association
The NLA is a multidisciplinary specialty society focused on prevention of cardiovascular disease and other lipid-related disorders. The NLA’s mission is to enhance the practice of lipid management in clinical medicine; one of its goals is to enhance efforts to reduce death and disability related to disorders of lipid metabolism in patients. Members include physicians (MDs and DOs), as well as allied health clinical team members, including PhD researchers, nurses, nurse practitioners, physician assistants, pharmacists, exercise physiologists and dietitians.