Understanding The New European Cholesterol Guidelines in Under 5 Minutes: Lipoprotein(a) for All
The most exciting meeting for American cardiologists in 2019 may well be one that took place in Paris, France just a few weeks ago. The buzz over new studies and 5 new guidelines from the European Society of Cardiology (ESC) was worldwide and made many media headlines. The guideline on cholesterol disorders, known as dyslipidemia, was of particular note as it reinforced the concept that LDL cholesterol causes vascular disease and illness and urged levels of cholesterol control unique to clinical practice. What were these recommendations?
Overview of Significant New Changes: Color Coded
The ESC guidelines made it plain and simple with an overview that was color coded of the biggest changes from the prior guidelines. One important change was the recommendation to consider obtaining a Lp(a) measurement at least once in all adults to identify high risk persons.
The Role of Vascular Imaging to Determine Risk
Although suggested over a decade ago by the SHAPE society, the new ESC guidelines emphasized obtaining a coronary artery calcium CT scan and/or a carotid or femoral ultrasound study to determine risk status.
Goals of LDL-Cholesterol Reduction Based on Risk
The new guidelines had the lowest LDL goals ever recommended so far including LDL-cholesterols under 40 mg/dl for the highest risk patients.
Overall Treatment Goals Were Summarized
Foods to Lower LDL-Cholesterol
Overall, the new ESC guidelines forge new ground with support for routine Lp(a) testing at least once in all individuals, the role of vascular imaging in risk assessment, and lower treatment targets to reduce residual risk. The guidelines are an exciting advance in the goal of prevention, early detection, and reversal of atherosclerosis.