New cholesterol treatment guidelines 2013
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Transcript of New cholesterol treatment guidelines 2013
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New Cholesterol Treatment
Guideline-2013ACC-AHA Task
Force Practice Guidelines November 12, 2013,
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AlgorithmPatients >21 yr. of age without heart failure (NYHA class II, III, or IV) or end-stage renal disease (undergoing haemodialysis) Screen for cardiovascular risk factors, measure LDL cholesterol
Clinical atheroscleroticCVD
Clinical atherosclerotic
CVD
DM I or II & age of 40–75 yr and LDL 70–189 mg/dl
No DM & age of 40–75 yr & LDL 70–189 mg/dl
LDL ≥ 190 mg/dl
High-intensity statin therapy
Calculate 10-yr risk of atherosclerotic CVD
Calculate 10-yr risk of atheroscleroticCVD
High-intensity statin therapy
If risk <7.5%, moderateintensitystatin therapy If risk .7.5%, high-intensity statin therapy
If risk .7.5%, moderate-tohigh-intensity statin therapy
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Intensity of statin therapy
High-intensity statin therapy Moderate-intensity statin therapy
Daily dose lowers LDL cholesterol level by approximately ≥50% on average
Recommended: atorvastatin, 40 to 80 mg rosuvastatin, 20 to 40 mg
Daily dose lowers LDL cholesterol level by approximately 30 to <50% on average
Recommended: atorvastatin, 10 to 20 mg; rosuvastatin, 5 to 10 mg; simvastatin,20 to 40 mg; pravastatin, 40 to 80 mg; lovastatin, 40 mg; extended-release fluvastatin,80 mg; fluvastatin, 40 mg twice a day; pitavastatin, 2 to 4 mg
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10 Year risk score calculator
• http://my.americanheart.org/cvriskcalculator or at http://www.cardiosource.org/
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Advantage
Only StatinsOnly LDL-Cholesterol
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Limitation: No Rx for Below 21 Years Above 75 yrs. without atheromatous disease
Other risk factor like family Hx of Premature atheromatous disease have not been taken into consideration