Dyslipidemia Guidelines

Key Metrics and Targets

• LDL-C:

  • High risk: 2 mmol/L or 50% decrease
  • Intermediate risk: Consider treatment if LDL-C <3.5 mmol/L
  • Low risk: Statins generally not indicated

• Apo B:

  • High risk: 0.8 g/L
  • Intermediate risk: Consider if Apo B 1.2 g/L

• Non-HDL-C:

  • High risk: 2.6 mmol/L
  • Intermediate risk: Consider if Non-HDL-C 4.3 mmol/L

Risk Assessment

• Framingham Risk Score (FRS):

  • High Risk: >20%
  • Intermediate Risk: 10-19%
  • Low Risk: <10%

• Age Points:

  • Men: Starts at age 30 (0 points) to 75+ (15 points)
  • Women: Starts at age 30 (0 points) to 75+ (12 points)

• HDL-C Levels:

  • 1.6 mmol/L: -2 points

  • <0.9 mmol/L: 2 points

• Total Cholesterol Levels:

  • <4.1 mmol/L: 0 points

  • 7.2 mmol/L: 4-5 points

• Systolic Blood Pressure (mmHg):

  • Not Treated: <120 mmHg: -2 to 0 points
  • Treated: <120 mmHg: -3 to -1 points

• Smoking and Diabetes:

  • Smoker: Yes or No
  • Diabetes: Yes (4 points) or No (0 points)

Treatment Considerations

• Statin-Indicated Conditions:

  • Clinical atherosclerosis
  • Abdominal aortic aneurysm
  • Diabetes mellitus (age and duration specific)
  • Chronic kidney disease

• Special Considerations:

  • LDL-C < 1.8 mmol/L for individuals with acute coronary syndrome within the past 3 months

Modified Framingham Risk Score

• Double CVD risk percentage for individuals aged 30-59 without diabetes but with a history of premature cardiovascular disease in a first-degree relative.

Conclusion

• Use the FRS to calculate 10-year CVD risk and determine patient risk levels.
• Adjust treatment plans based on risk assessment and lipid targets.

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Note:

• ApoB is apolipoprotein B, CVD is cardiovascular disease, HDL-C is high-density lipoprotein cholesterol, and LDL-C is low-density lipoprotein cholesterol.
• Statins are recommended as initial therapy in certain cases.