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[New guidelines on dyslipidemia management: Comparison of French (HAS) and European (ESC/EAS) guidelines].
La Presse Médicale 2018 September
Total cardiovascular risk estimation using a system such as SCORE is recommended for adults>40years of age without evidence of cardiovascular disease, diabetes, chronic kidney disease, severe hypertension or familial hypercholesterolemia. Before treatment, a full lipid profile is recommended, fasting in French guidelines, fasting or non-fasting in European guidelines. LDL-C has to be used as the primary target for treatment. For patients with elevated triglycerides, non-HDL-C level is also recommended as the secondary goal for treatment. In patients at very high and high cardiovascular risk, LDL-C goals are respectively below<0.70g/L and<1.0g/L. For subjects at very high and high cardiovascular risk, French guidelines do not mention that a≥50% reduction in LDL-C should be achieved. Statins are the treatment of choice to reach LDL-C goals. If the goal is not reached on maximally tolerated dose of statin, combination with another LDL lowering drug, mainly ezetimibe, is recommended. Fibrates are mainly proposed for patients with severe hypertriglyceridemia (TG>5g/L after lifestyle changes).
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