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Cholesterol guidelines

Om P Ganda, Joanna Mitri
Despite major advances, many patients with diabetes are currently achieving suboptimal control of lipids and blood pressure. The new cholesterol guidelines by the ACC/AHA have reignited the emphasis on more intensive treatment with statins in the population at high risk of CVD, including those with diabetes. While these guidelines do not include specific lipid goals, several other guidelines have retained previously defined risk-based LDL-C and non-HDL-C goals. More recent data indicate potential benefits in CVD outcomes with non-statin therapy added to statin therapy...
November 2016: Current Cardiology Reports
Valentina Barletta, Francesco Profili, Rosa Gini, Leonardo Grilli, Carla Rampichini, Daniela Matarrese, Paolo Francesconi
BACKGROUND: In 2010, Tuscany (Italy) implemented the Chronic Care Model (CCM), to improve general practitioner (GP) management of chronic diseases. AIM: assessing how the introduction of CCM affected GPs' compliance with standards of care for diabetes patients. METHODS: A controlled before-after study was performed. Two exposed groups of GPs, one entering the study in 2010 and one in 2011, were considered. Patients with diabetes assisted by GPs of the groups were identified through the healthcare administrative data of the Regional Healthcare System and followed up from 2009 to 2012...
October 15, 2016: European Journal of Public Health
Michael J Blaha, Joseph Yeboah, Mahmoud Al Rifai, Kiang Liu, Richard Kronmal, Philip Greenland
When the MESA (Multi-Ethnic Study of Atherosclerosis) began, the Framingham risk score was the preferred tool for 10-year global coronary heart disease risk assessment; however, the Framingham risk score had limitations including derivation in a homogenous population lacking racial and ethnic diversity and exclusive reliance on traditional risk factors without consideration of most subclinical disease measures. MESA was designed to study the prognostic value of subclinical atherosclerosis and other risk markers in a multiethnic population...
September 2016: Global Heart
Nasreen Al Sayed, Khalid Al Waili, Fatheya Alawadi, Saeed Al-Ghamdi, Wael Al Mahmeed, Fahad Al-Nouri, Mona Al Rukhaimi, Khalid Al-Rasadi, Zuhier Awan, Mohamed Farghaly, Mohamed Hassanein, Hani Sabbour, Mohammad Zubaid, Philip Barter
BACKGROUND: Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no region-specific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions. METHODS: A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East...
September 28, 2016: International Journal of Cardiology
Rosângela Dos Santos Ferreira, Rita de Cássia Avellaneda Guimarães, Elenir Rose Jardim Cury Pontes, Valter Aragão do Nascimento, Priscila Aiko Hiane
Cardiovascular events due to decompensated lipid metabolism are commonly found in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) patients using anti-retroviral therapy (HAART). Thus, the aim of this study was to identify the effect of a bioactive food compound (BFC) containing functional foods on individuals with HIV undergoing HAART. Particularly, this study aims to verify the clinical outcome in the change of the lipid profile due to the use of this compound. This study includes 115 individuals with HIV on HAART...
October 8, 2016: Nutrients
Naresh Malhotra, M K Keshan, Avinash Agarwal, R Anil Kumar, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
BACKGROUND: Cardiovascular diseases (CVD's) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy...
April 2016: Journal of the Association of Physicians of India
Nancy R Cook, Paul M Ridker
The latest guidelines from the American College of Cardiology and American Heart Association, released in fall 2013, provide a long-anticipated update to the recommendations of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). The guidelines incorporate a new risk score for atherosclerotic cardiovascular disease that includes stroke as well as coronary heart disease. After publication, the new pooled cohort equations (PCEs) were evaluated in 15 studies from the United States and Europe, most of which used cohorts that were more contemporary than those used in developing the guidelines...
October 11, 2016: Annals of Internal Medicine
Todd J Anderson, Jean Grégoire, Glen J Pearson, Arden R Barry, Patrick Couture, Martin Dawes, Gordon A Francis, Jacques Genest, Steven Grover, Milan Gupta, Robert A Hegele, David C Lau, Lawrence A Leiter, Eva Lonn, G B John Mancini, Ruth McPherson, Daniel Ngui, Paul Poirier, John L Sievenpiper, James A Stone, George Thanassoulis, Richard Ward
Since the publication of the 2012 guidelines new literature has emerged to inform decision-making. The 2016 guidelines primary panel selected a number of clinically relevant questions and has produced updated recommendations, on the basis of important new findings. In subjects with clinical atherosclerosis, abdominal aortic aneurysm, most subjects with diabetes or chronic kidney disease, and those with low-density lipoprotein cholesterol ≥ 5 mmol/L, statin therapy is recommended. For all others, there is an emphasis on risk assessment linked to lipid determination to optimize decision-making...
July 25, 2016: Canadian Journal of Cardiology
Pamela A Kushner, Michael E Cobble
This review aims to explain risk factors, consequences, and management strategies recommended for patients with hypertriglyceridemia. A search of PubMed was performed: "Hypertriglyceridemia"[Majr], limited to English-language and published in the 5 years up to April 2016. Abstracts of the 680 results were screened for inclusion. Reference lists of publications included were also screened for inclusion. Approximately 25% of the United States population has elevated (≥150 mg/dL) triglycerides (TG) putting them at an increased risk of cardiovascular disease, non-alcoholic fatty liver disease, and pancreatitis...
October 6, 2016: Postgraduate Medicine
Ross T Tsuyuki, Meagen Rosenthal, Glen J Pearson
BACKGROUND: Dyslipidemia is an important risk factor for cardiovascular disease but is suboptimally managed. Pharmacists are accessible primary care professionals and with expanded scopes of practice (including prescribing), could identify and manage patients with dyslipidemia. We sought to evaluate the effect of pharmacist prescribing of dyslipidemia medications on the proportion of participants achieving target LDL-cholesterol (LDL-c) levels. METHODS: We conducted a randomized controlled trial in 14 community pharmacies in Alberta, Canada...
September 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Frederico F Vaz, Rosangela Locatelli-Dittrich, Olair C Beltrame, Elenise A B Sipinski, Maria C Abbud, Rafael M Sezerban
BACKGROUND: The Red-Tailed Amazon parrot (Amazona brasiliensis) is an endangered species of the Psittaciformes. There is little information about hematologic and biochemical variables of this species. OBJECTIVES: The purpose of this study was to determine hematologic and biochemical RIs for free-living A brasiliensis nestlings on Rasa Island, Paraná, Brazil, and to compare the results between sexes. METHODS: Thirty-seven parrots were taken from their nests and physically restrained for clinical examination and blood collection...
October 4, 2016: Veterinary Clinical Pathology
Zoë Harcombe, Julien S Baker, Bruce Davies
OBJECTIVES: National dietary guidelines were introduced in 1977 and 1983, by the US and UK governments to reduce coronary heart disease (CHD) mortality by reducing dietary fat intake. Our 2016 systematic review examined the epidemiological evidence available to the dietary committees at the time; we found no support for the recommendations to restrict dietary fat. The present investigation extends our work by re-examining the totality of epidemiological evidence currently available relating to dietary fat guidelines...
October 3, 2016: British Journal of Sports Medicine
Begoña Ruiz-Núñez, D A Janneke Dijck-Brouwer, Frits A J Muskiet
The mantra that dietary (saturated) fat must be minimized to reduce cardiovascular disease (CVD) risk has dominated nutritional guidelines for decades. Parallel to decreasing intakes of fat and saturated fatty acids (SFA), there have been increases in carbohydrate and sugar intakes, overweight, obesity and type 2 diabetes mellitus. The "lipid hypothesis" coined the concept that fat, especially SFA, raises blood low-density lipoprotein-cholesterol and thereby CVD risk. In view of current controversies regarding their adequate intakes and effects, this review aims to summarize research regarding this heterogenic group of fatty acids and the mechanisms relating them to (chronic) systemic low-grade inflammation, insulin resistance, metabolic syndrome and notably CVD...
October 2016: Journal of Nutritional Biochemistry
Ghada Asaad, Diana C Soria-Contreras, Rhonda C Bell, Catherine B Chan
Type 2 diabetes (T2D) patients often find integrating a new dietary pattern into their lifestyle challenging; therefore, the PANDA (Physical Activity and Nutrition for Diabetes in Alberta) menu plan intervention was developed to help people incorporate the Canadian Diabetes Association (CDA) nutrition therapy guidelines into their daily lives. The menu plan focused on recipes and foods that were accessible, available and acceptable to Albertans. The objective was to evaluate the effectiveness of the intervention on blood glucose control and dietary adherence and quality among patients with T2D...
2016: Healthcare (Basel, Switzerland)
Lotte Kaasenbrood, S Matthijs Boekholdt, Yolanda van der Graaf, Kausik K Ray, Ron J G Peters, John J P Kastelein, Pierre Amarenco, John C LaRosa, Maarten J M Cramer, Jan Westerink, L Jaap Kappelle, Gert Jan de Borst, Frank L J Visseren
BACKGROUND: -Among patients with clinically manifest vascular disease, the risk of recurrent vascular events is likely to vary. We assessed the distribution of estimated 10-year risk of recurrent vascular events in a secondary prevention population. We also estimated the potential risk reduction, as well as the residual risk, that can be achieved if patients reach guideline-recommended risk factor targets. METHODS: -The SMART (Second Manifestations of ARTerial disease) score for 10-year risk of myocardial infarction, stroke or vascular death was applied to 6,904 patients with vascular disease...
September 28, 2016: Circulation
Pavel Grasgruber, Martin Sebera, Eduard Hrazdira, Sylva Hrebickova, Jan Cacek
BACKGROUND: The aim of this ecological study was to identify the main nutritional factors related to the prevalence of cardiovascular diseases (CVDs) in Europe, based on a comparison of international statistics. DESIGN: The mean consumption of 62 food items from the FAOSTAT database (1993-2008) was compared with the actual statistics of five CVD indicators in 42 European countries. Several other exogenous factors (health expenditure, smoking, body mass index) and the historical stability of results were also examined...
2016: Food & Nutrition Research
Thomas Knickelbine, Matthew Lui, Ross Garberich, Michael D Miedema, Craig Strauss, Jeffrey J VanWormer
BACKGROUND: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease resulting in elevated serum low-density lipoprotein cholesterol (LDL-C) levels. Patients with FH have a very high lifetime risk of cardiovascular disease, but FH often goes unrecognized in clinical care. New treatments including PCSK9 inhibitors are now available for this population, and the use of the electronic record may be able to help identify potential patients for therapy. OBJECTIVES: The goal of this study was to determine the period prevalence of FH in a large ambulatory care population, including the homozygous form...
September 2016: Journal of Clinical Lipidology
Nathan D Wong, Daphnee Young, Yanglu Zhao, Huy Nguyen, Jared Caballes, Irfan Khan, Robert J Sanchez
BACKGROUND: The 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline identifies 4 statin-eligible groups: (1) known atherosclerotic cardiovascular disease (ASCVD) aged ≥21 years, (2) low-density lipoprotein cholesterol (LDL-C) ≥ 190 mg/dL (4.9 mmol/L) aged ≥21 years, (3) diabetes mellitus aged 40 to 75 years with LDL-C 70 to 189 mg/dL (1.8-4.9 mmol/L), or (4) ≥7.5% 10-year ASCVD risk aged 40 to 75 years with LDL-C 70 to 189 mg/dL (1...
September 2016: Journal of Clinical Lipidology
S Saraf-Bank, F Haghighatdoost, A Esmaillzadeh, B Larijani, L Azadbakht
BACKGROUND/OBJECTIVES: Nowadays, metabolic syndrome (MetS) is deemed as a major public health challenge in both developed and developing countries. Therefore, the aim of this study was to determine the association between Healthy Eating Index-2010 (HEI-2010) score and MetS and its features among Iranian female nurses. SUBJECTS/METHODS: This cross-sectional study was performed among 1036 Iranian women. A validated, self-administered, dish-based, semiquantitative food frequency questionnaire was used to assess the habitual intake of participants...
September 28, 2016: European Journal of Clinical Nutrition
Jennifer G Robinson
PURPOSE OF REVIEW: Factors influencing guideline development may result in paradigm shifts in treatment recommendations. RECENT FINDINGS: The 2013 American College of Cardiology/American Heart Association cholesterol guideline provides an example of how new methodology and findings from randomized clinical trials can result in a paradigm shift in the approach to cardiovascular prevention. This guideline moved away from a treat to cholesterol goal approach. Based on strong evidence of a net benefit in randomized clinical trials, statins were recommended to reduce atherosclerotic cardiovascular disease risk in four groups of patient most likely to benefit...
September 26, 2016: Current Opinion in Lipidology
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