One of the breakout sessions I listened to through the AADE11 Virtual Meeting was “Cardiovascular Risk Calculators and Non-lipid Disease Markers-Applying New Cholesterol Guidelines,” presented by Evan Sisson, PharmD, MHA, CDE. The National Heart Blood and Lung Institute is releasing new guidelines this December and he speculated what the guidelines would include.
I am an RD, CDE and since I do not work directly with prescribing medications, sometimes all the cholesterol and blood pressure medications (and why certain ones would be prescribed over others) confuse me and I was hoping by participating in this lecture that it would help me sort things out.
There are several different assessments out there to measure cardiovascular risks and Mr. Sisson discussed the differences as well as pros and cons. Some examples discussed were:
No wonder there is confusion surrounding this topic! There are so many different tools and systems that assess CVD risk. Dr. Sisson suggested that the new guidelines will most likely include global risk calculators for more consistency in risk assessment.
He also predicted that the following would be included in the new guidelines coming out this December:
We will see more of the use of non-HDL. If you are not familiar with non-HDL, it is the total of VLDL and LDL. To calculate non-HDL, subtract HDL from total cholesterol. Dr. Sisson explained that non-HDL was helpful for tracking cholesterol in the non-fasting state - which is more convenient for patients.
Checking hsCRP (high-sensitivity C-reactive protein) and/or Lp-PLa2 (Lipoprotein-associated phospholipase) is good once patients have been on therapy for a while and not necessarily at initial diagnosis as a measurement of inflammation.
LDL levels should stay above 25mg/dl with drug therapy.
Statin use is safe with studies showing no increased risk of stroke or cancer. Using the risk assessment tools, 30 year CVD risk should be used when deciding when to start a patient on Statin therapy.
Niacin is a great partner with Statin use since it lowers cardiovascular events and does not increase mortality. It also helps increase HDL.
If you attended “Cardiovascular Risk Calculators and Non-lipid Disease Markers-Applying New Cholesterol Guidelines,” I would love to know some things you learned. Share with us!