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World J Cardiol. Feb 26, 2016; 8(2): 201-210
Published online Feb 26, 2016. doi: 10.4330/wjc.v8.i2.201
Dyslipidemia management in primary prevention of cardiovascular disease: Current guidelines and strategies
Aditya D Hendrani, Tolulope Adesiyun, Renato Quispe, Steven R Jones, Neil J Stone, Roger S Blumenthal, Seth S Martin
Aditya D Hendrani, Department of Medicine, Medstar Union Memorial Hospital, Baltimore, MD 21239, United States
Tolulope Adesiyun, Renato Quispe, Steven R Jones, Roger S Blumenthal, Seth S Martin, Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
Neil J Stone, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
Author contributions: Hendrani AD and Martin SS drafted this paper and all authors made critical revisions to develop the final manuscript.
Conflict-of-interest statement: No potential conflicts of interest, no financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seth S Martin, MD, MHS, FACC, Assistant Professor of Medicine and Cardiology, Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Carnegie 591, Baltimore, MD 21287, United States. smart100@jhmi.edu
Telephone: +1-410-9557376 Fax: +1-410-6149190
Received: June 28, 2015
Peer-review started: July 11, 2015
First decision: September 17, 2015
Revised: November 22, 2015
Accepted: December 4, 2015
Article in press: December 8, 2015
Published online: February 26, 2016
Abstract

Cardiovascular disease is the leading cause of death in the United States. In 2010, the Centers for Disease Control and Prevention estimated that $444 billion was spent on cardiovascular diseases alone, about $1 of every $6 spent on health care. As life expectancy continues to increase, this annual cost will also increase, making cost-effective primary prevention of cardiovascular disease highly desirable. Because of its role in development of atherosclerosis and clinical events, dyslipidemia management is a high priority in cardiovascular prevention. Multiple major dyslipidemia guidelines have been published around the world recently, four of them by independent organizations in the United States alone. They share the goal of providing clinical guidance on optimal dyslipidemia management, but guidelines differ in their emphasis on pharmacotherapy, stratification of groups, emphasis on lifestyle modification, and use of a fixed target or percentage reduction in low density lipoprotein cholesterol. This review summarizes eight major guidelines for dyslipidemia management and considers the basis for their recommendations. Our primary aim is to enhance understanding of dyslipidemia management guidelines in patient care for primary prevention of future cardiovascular risk.

Keywords: Dyslipidemia, Guidelines, Cardiovascular diseases

Core tip: Guidelines for dyslipidemia management have been developed by independent organizations internationally for the purpose of improving patient care and reducing costs related to cardiovascular disease. In this review article, we briefly summarize the key strategies suggested by each of eight major dyslipidemia guidelines, and the evidence that forms the foundation of the recommendations. We attempt to present a balanced view, commenting on potential strengths and weaknesses of each approach. Overall, we aim to enhance understanding of dyslipidemia management guidelines for primary prevention of future cardiovascular events.