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Update on Guidelines for Management of Hypercholesterolemia

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Update on Guidelines for Management of Hypercholesterolemia

Abstract and Introduction

Abstract


Coronary heart disease (CHD) is a leading cause of morbidity and mortality globally. Hypercholesterolemia is one of the major risk factors for CHD. With the increase in aging populations and progressively sedentary lifestyles, the global burden of CHD is likely to increase in the future despite better preventive strategies. It is vitally important to manage hypercholesterolemia effectively because it is a modifiable risk factor. At present, there are several guidelines with differences in recommendations. In this paper the authors present an update on the guidelines on hypercholesterolemia management. The authors have systematically reviewed guidelines in hypercholesterolemia management and discussed a pragmatic approach to follow the most recent guidelines including guidance from NICE in the primary care setting.

Introduction


Coronary heart disease (CHD) remains the number one cause of death for both men and women in developed countries, and the global burden of cardiovascular disease (CVD) is expected to rise. In England alone, each year it kills more than 110,000 people and 275,000 people have a heart attack annually. Furthermore, each year over 1 million people endure angina symptoms. By 40 years of age almost half of men and almost one third of women are at risk of CHD at some point in their lives according to the Framingham Heart Study. By the age of 70 years, the risk is just less than a third of men and a quarter of women. CHD and stroke are the first and fourth most common causes of mortality and morbidity globally, respectively.

Globally, the world population is expected to rise from 5.71 billion in 1995 to 8.29 billion by 2025. Combined with changes in the demographic profile and the increasing westernization of developing countries, this will result in large numbers of adults who are potentially vulnerable to CHD. CHD mortality has a linear relation with cholesterol. There is conclusive evidence from the literature to show that higher levels of serum cholesterol contribute significantly to CHD and CVD. Conversely the risk of these conditions is reduced by lowering serum cholesterol.

Therefore, prevention of CVD by treating hypercholesterolemia is an important step in reducing coronary morbidity and mortality. The purpose of this study is to review the guidelines on the evaluation and management of hypercholesterolemia in primary and secondary prevention.

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