NLA Recommendations & Statements

Despite the established role of low-density lipoprotein cholesterol (LDL-C) as a major risk factor for cardiovascular disease (CVD), and the persistence of CVD as the leading cause of morbidity and mortality in the United States, national quality assurance metrics no longer include LDL-C measurement as a required performance metric. This clinical perspective reviews the history of LDL-C as a quality and performance metric and the events that led to its replacement. It also presents patient, healthcare provider, and health system rationales for re-establishing LDL-C measurement as a performance measure to improve cholesterol control in high-risk groups and to stem the rising tide of CVD morbidity and mortality, cardiovascular care disparities, and related healthcare costs.

Statin-associated muscle symptoms (SAMS) are the most common form of statin intolerance and are associated with increased risk of cardiovascular events that manifest from statin underutilization and discontinuation. 

Dyslipidemia, or high cholesterol, means you have too many lipids (fat) in your blood. Nutrition interventions in youth with dyslipidemia provide short- and long-term benefits without adverse effects on growth or maturation. Counseling by a registered dietitian nutritionist (RDN) is strongly recommended to help youth and their families successfully alter dietary intake to meet nutritional needs, provide ongoing support, and encourage long-term adherence to healthy nutrition and exercise patterns.

The statement provides updates on the evidence-based facts about statins and statin intolerance and makes practical recommendations to aid clinicians in determining a therapeutic objective in contemporary clinical practice. Statin intolerance is defined as one or more adverse effects associated with statin therapy which resolve or improve with dose reduction or discontinuation and can be classified as a complete inability to tolerate any dose of a statin, or partial intolerance with inability to tolerate the dose necessary to achieve the patient-specific therapeutic objective.

The NLA has released an official scientific statement on the use of genetic testing in the diagnosis and management of patients with dyslipidemia. The statement provides insights and guidance for health care providers seeking to further their understanding of the benefits, risks and patient preferences of genetic testing. 

The NLA has released a Clinical Perspective to provide strategies for early screening and education of the community and their healthcare providers, and offer practical prevention strategies and culturally-tailored dietary advice to lower the rates of ASCVD in this cohort.

This statement provides updates on the evidence-based appropriate use of CAC scoring and makes practical recommendations to aid clinicians in primary prevention treatment decision-making in contemporary clinical practice. 

The NLA has published a scientific statement on the use of icosapent ethyl (IPE) in statin-treated patients that is based on the results of REDUCE-IT, the cardiovascular outcomes trial that examined the effects of IPE on major adverse cardiovascular events in high or very high-risk statin-treated patients with elevated triglycerides.

The NLA has released a scientific statement that analyzes the impact of low-carbohydrate and very-low-carbohydrate diets (including ketogenic diets) on cardiometabolic risk factors and body weight. The statement offers conclusions regarding the potential benefits, risks, and evidence gaps regarding low-carbohydrate and very-lowcarbohydrate diets and emphasizes the importance of an evidence-based cardioprotective dietary pattern and active lifestyle to promote cardiovascular health.