Abstract

MORALES BRICENO, Eduardo  and  ACQUATELLA, Harry. Nuevas Guías para el tratamiento de los aumentos de colesterol: Riesgos versus metas. Gac Méd Caracas. [online]. 2017, vol.125, n.4, pp.266-275. ISSN 0367-4762.

Elevated blood cholesterol is one of the most important modifiable cardiovascular risk factors, in addition with health style modifications and medical therapies proven to reduce both cardiovascular disease incidence and related mortality. The risk for heart disease goes up as the LDL-cholesterol rises and the number of heart disease risk factors increase. Since the “Lipid Hypothesis”, the present review presents the new 2013 Guideline from the American College of Cardiology, the American Heart Association in conjunction with the National Heart, Lung, Blood Institute (ACC/AHA/NHLBI). The newer approach was to shift away from the practice of treating lipids targets to specific goals (LDL-C and NON HDL-C). Instead the guidelines recommended moderate to high intensity statin therapy for groups of patients most likely to achieve maximal benefit based on their increased risk of 7.5 % or more at 10 years follow-up. Statins remains the cornerstone of treatment because of their proven benefits and cost-effectiveness. In addition reducing LDL-C levels with NON statins medication will reduce the risk of atherosclerotic heart disease in proportion to the decrease of LDL-C level. Ezetimibe in less degree, and recently more effective the Protein Convertasa Subtilisin/Kexin type 9 inhibitors (PCSK9) injectable monoclonal antibodies used in addition to diet and statin therapy could reduce the LDL-C levels to 50 %-80 % with a significant decrease in cardiovascular disease events in special population of patients.

Keywords : Cardiovascular risk; Lipid hypothesis; Coronary disease; LDL cholesterol; DHL cholesterol; Statins; Ezetimibe.

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