Lipoprotein management in patients with cardiometabolic risk: Consensus statement from the American diabetes association and the american college of cardiology foundation

Abstract

Patients with cardiometabolic risk factors represent a group at high lifetime risk for CVD. These patients frequently have dyslipoproteinemia (low HDL cholesterol, increased triglycerides, and/or an increased number of small LDL particles). We recommend an assessment of global risk followed by a multifactorial risk reduction strategy for such individuals targeting each risk factor and emphasizing both lifestyle and pharmacologic therapy. In terms of dyslipoproteinemia, we recommend the following: Statin therapy for the majority of dyslipoproteinemic adult patients with CMR For patients with CMR on statin therapy, guiding therapy with measurements of apoB and treatment to apoB goals in addition to LDL cholesterol and non-HDL cholesterol assessments Treatment goals, summarized in Table 1, that address the high lifetime risk of patients with dyslipoproteinemia and CMR. Clinical trials to determine whether the pharmacologic therapy required to achieve very low levels of atherogenic lipoproteins is safe and cost-effective A concerted, multifaceted, public health effort, focused on lifestyle mod-ification, to reduce mean population levels of atherogenic lipoproteins to values well below current ones. © 2008 by the American Diabetes Association.