Recommendations of the European association of cardiologists and the European association of atherosclerosis for the diagnosis and treatment of dyslipidemia: lipid modification to reduce cardiovascular risk
In 2019, the European Association of cardiologists together with the European Association of atherosclerosis presented at the Congress of the European society of cardiology updated recommendations for the diagnosis and treatment of dyslipidemia. The purpose of their formation is to use the latest achievements of medical science on lipid modification as a central intervention in improving cardiovascular prognosis and reducing mortality. Prevention of cardiovascular diseases in the patient is based on the assessment of the total cardiovascular risk - the higher it is, the more active the preventive measures should be. For the first time, calibrated versions of the SCORE scale for European regions of different cardiovascular risk were proposed. Clinical groups of different cardiovascular risk are formulated, for each of which individual target lipid levels are proposed. As risk modifiers in asymptomatic patients of low or moderate risk, the data of modern methods of visualization of the cardiovascular system, as well as the definition of coronary calcium, are considered. The position of European experts regarding indications for initiation of drug lipid-lowering therapy has changed. Thus, patients of any risk level, even low and moderate, if the initial level of low-density lipoprotein cholesterol exceeds its target values, are recommended not only lifestyle modification, but also the use of drug correction. Drug correction of hypercholesterolemia involves high-intensity statin therapy in the maximum tolerated doses, as well as the possible use of combination therapy with the addition of ezetimibe and PCSK9 blockers. The 2019 European guidelines discuss in detail the features of lipid modification in selected clinical situations.