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Preventing Heart Attacks and Death in Patients with Atherosclerotic Cardiovascular Disease
Lipid Management2
Primary Goal: LDL < 100 mg/dL
Start dietary therapy in all patients (< 7% saturated fat and < 200 mg/dL cholesterol) and promote physical activity and weight management. Increased consumption of omega-3 fatty acids should be encouraged. A fasting lipid profile should be assessed in all patients, and within 24 hours of hospitalization for those with an acute coronary event. For hospitalized patients, the initiation of drug therapy on discharge should be considered. |
AHA/ACC Drug Therapy Guidelines2
LDL < 100 mg/dL
(Baseline or On-Treatment) |
LDL 100 – 129 mg/dL
(Baseline or On-Treatment) |
LDL > 130 mg/dL
(Baseline or On-Treatment) |
Further LDL-lowering therapy is not required.
If low HDL or high triglycerides, consider |
Therapeutic Options:
- Intensify LDL-lowering therapy (statin or resin*)
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Intensify LDL-lowering therapy (statin or resin*). Add or increase drug therapy with lifestyle |
| fibrate or niacin. |
- If low HDL or high triglycerides, fibrate or niacin may be recommended or combined drug therapy (statin + fibrate or niacin) may be considered. |
therapies. |
- Secondary Goal: If triglycerides are > 200 mg/dL, then non-HDL† should be < 130 mg/dL.2
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If triglycerides are > 150 mg/dL or HDL is < 40 mg/dL, weight management and physical activity should be emphasized, and smoking cessation should be advised |
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If triglycerides are in the range of 200 – 499 mg/dL, fibrate or niacin should be considered after LDL-lowering therapy *
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If triglycerides are > 500 mg/dL, fibrate or niacin should be considered before LDL-lowering therapy*
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Omega-3 fatty acids should be considered as an adjunct for high triglycerides
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For more information on cholesterol guidelines, click here.
For more information on therapies used to lower blood cholesterol levels, click here.
For more information on the American Heart Association, their recommendations for risk prevention or their Get With The GuidelinesSM program, click here.
• Smoking Cessation and Smoke Avoidance
• Blood Pressure Control
• Lipid Management
• Physical Activity
• Weight Management
• Diabetes Management
• Antiplatelet Agents / Anticoagulants
• ACE Inhibitors
• Beta-Blockers
* The use of resin is relatively contraindicated when triglycerides are > 200 mg/dL.
† Non-HDL cholesterol equals total cholesterol minus HDL cholesterol.
References |
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