The evolution of European guidelines: changing the management of cholesterol levels

Atherosclerosis. 2006 Mar;185(1):12-20. doi: 10.1016/j.atherosclerosis.2005.10.001. Epub 2005 Nov 23.

Abstract

Cardiovascular disease (CVD) is the leading cause of death in Europe and the US. This paper reviews the evolution of the Joint European Societies' guidelines with respect to their lipid recommendations. We stress the importance of lowering lipid levels to, or below, the currently recommended goals and argue that patients' global risk for CVD, rather than baseline lipid levels, should direct the intensity of lipid-lowering treatment. However, the emphasis on near-term (i.e., in the next 10 years) global risk estimation may under-emphasize the importance of considering lifetime cardiovascular risk in treatment decisions. Although various guidelines' thresholds for treatment initiation and recommended goals differ, they are similar in the theme of treating global risk. Most clinical trials have not identified a threshold of cholesterol level beyond which lowering cholesterol levels no longer provides cardiovascular benefit. An urgent call for action is needed to improve goal attainment in patients with or at risk for CVD. Improving access to risk-reducing treatments should be a priority.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents / therapeutic use*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol / blood*
  • Europe
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / complications
  • Hypercholesterolemia / drug therapy*
  • International Cooperation
  • Practice Guidelines as Topic*
  • Risk Factors
  • Treatment Outcome

Substances

  • Anticholesteremic Agents
  • Cholesterol