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Statins Use

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In no more than 1-2 paragraphs discuss the major differences (controversies) between the new ACC/AHA’s Guidelines on the treatment of cholesterol and the “old” lipid guidelines known as ATP III (Adult treatment plan III). What are your thoughs on these changes?

Lipid management over the last decade has been utilizing guidelines from the 3rd report of the National Cholesterol Education Program. In November 2013 new guidelines were established with controversy regarding some of the changes that were to be made. The 2013 AHA/ACC lipid guidelines provide a new method to the management of hyperlipidemia, which differs from the ATP-III guidelines. The new guidelines created differ in that it includes the change from treating target levels or lab tests to treatment based on risk level and intensity of statin therapy. They identified 4 groups that would likely benefit from statin therapy: * History of arteriosclerotic cardiovascular disease (ASCVD) * LDL- cholesterol >190 mg/dl * Between 40-75 years of age with history of diabetes * Between 40-75 year of age and a 10-year ASVD Risk > 7.5%

A second key difference is lack of LDL goals in order to monitor the effectiveness of cholesterol lowering medications. There were no recommendations made on follow up LDL testing, which differs from previous guidelines. The best way to accomplish the AHA/ACC recommended goals is to focus on decreasing cardiovascular disease events or ASCVD.
Another major change to the guidelines states that non-statin therapies do not provide acceptable ASCVD risk reduction benefits compared to their potential for adverse effects. This recommendation will decrease the amount of non- statin medication being used for treatment. Another change made by the ACC/AHA was utilization of a pooled cohort risk assessment instead of the Framingham Risk Calculator to estimate 10-year risks...

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