The 2013 American Heart Association/American College of Cardiology (AHA/ACC) cholesterol guidelines sparked headlines and hot medical debate around the world, says Marc Penn, MD, PhD, FACC, Co-Founder and Chief Medical Officer of Cleveland HeartLab and Director of Research of Summa Cardiovascular Institute.
“Nearly a year later, there’s still widespread confusion about what clinicians should do with such dramatically changed guidelines for treating elevated cholesterol, a major risk factor for cardiovascular disease (CVD), the leading cause of death in the United States,” says Dr. Penn, who will be moderating “The Great Debate,” aimed at answering such compelling questions as, “Can we resolve the controversy?” and “Where do the new guidelines lead us?”
“News reports about the guidelines took a very unfortunate spin by focusing on the lack of any specific target number for LDL, which created considerable confusion and even the misconception that LDL was no longer a treatment target,” says Great Debate panelist Christie Ballantyne, MD, FACC, FACP, Chief, Cardiovascular Research Section, Baylor College of Medicine and Director, Center for CVD Prevention, Methodist DeBakey Heart Center.
“Actually, we shouldn’t take the focus off LDL cholesterol, which plays a critical role in atherosclerosis,” continues Dr. Ballantyne. “Instead of targeting a number, we should focus on the fact that many patients with elevated cholesterol are not getting an effective dose of statins–or aren’t treated at all.” About 50 percent of patients who suffer a heart attack or stroke have high cholesterol, according to the AHA.
“The good news is that rather than trying to drive every patient’s cholesterol down to targets advised by the old guidelines–and risk having patients quit treatment because of statin side effects–the new guidelines allow you to personalize care,” emphasizes Dr. Penn. Now the goal is based on the person’s initial LDL levels, with a reduction of more than 50 percent advised if high-intensity statin therapy is used, or a reduction of 30 to 50 percent with moderate-intensity therapy.