Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지
DOI QR코드

DOI QR Code

Current Guidelines on the Management of Dyslipidemia

이상지질혈증의 국내 및 국외 치료 가이드라인 비교

  • Choi, Yunjeong (College of Pharmacy, Chungbuk National University) ;
  • Lee, Song (College of Pharmacy, Chungbuk National University) ;
  • Kim, Ju Young (College of Pharmacy, Chungbuk National University) ;
  • Lee, Kyung Eun (College of Pharmacy, Chungbuk National University)
  • Received : 2017.11.08
  • Accepted : 2017.12.04
  • Published : 2017.12.29
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: Dyslipidemia is recognized as a prominent risk factor for cardiovascular and cerebrovascular diseases but it is manageable through therapeutic and lifestyle intervention. Interpreting the latest guidelines is essential for an application of recommendation from guidelines into clinical practice. Therefore, this study aimed to compare the most recent guidelines on dyslipidemia treatment recommendations in Korea and USA. Methods: This study analyzed and compared 2015 Korean guidelines for the management of dyslipidemia, 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline and 2016 supportive guidelines from ACC. Results: A comparison was made focused on the following: target patients based on cardiovascular risk assessment, target goal, and treatment strategies including statin and non-statin therapies. Four target patient groups by risk were suggested in 2015 Korean guideline and cardiovascular risk factors were also considered for initiation of lipid lowering therapy. Titrated statin regimen was recommended by Korean guideline to reach LDL cholesterol and non-HDL cholesterol target level. In 2013 ACC/AHA guideline, four statin benefit group was introduced considering ASCVD risk and high intensity statin or intermediate intensity statin use were recommended without dose titration. 2016 update was to support non-statin therapy based on updated evidence and new consideration of ezetimibe, PCSK9-inhibitor and bile acid sequestrant was brought up. Conclusion: Guidelines are continuously updating as new and important clinical data are constantly released along with the advent of newly approved drugs for lipid disorder. This article provides resources that facilitates uptake of these recommendations into clinical practice.

Keywords

References

  1. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017;135(10):e146-e603. https://doi.org/10.1161/CIR.0000000000000485
  2. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2015. Korea National Health and Nutrition Examination Survey (KNHANES VI-3). Available from https://knhanes.cdc.go.kr. Accessed October 1, 2017.
  3. Kim HC. Epidemiology of dyslipidemia in Korea. J Korean Med Assoc. 2016;59(5):352-7. https://doi.org/10.5124/jkma.2016.59.5.352
  4. Ministry of Health and Welfare of Korea. The National Health Plan 2020. Seoul: Ministry of Health and Welfare of Korea: 2011. Available from http://www.khealth.or.kr/hp2020. Accessed October 1, 2017.
  5. Committee for Guidelines for Management of Dyslipidemia. 2015 Korean Guidelines for Management of Dyslipidemia. Korean Circ J 2016;46(3):275-306. https://doi.org/10.4070/kcj.2016.46.3.275
  6. Stone NJ, Robinson JG, Lichtenstein AH, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:S1-S45. https://doi.org/10.1161/01.cir.0000442729.75315.83
  7. Lloyd-Jones DM, Morris PB, Ballantyne CM, et al. 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 2016;68:92-125. https://doi.org/10.1016/j.jacc.2016.03.519
  8. Goff DC, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2935-59. https://doi.org/10.1016/j.jacc.2013.11.005
  9. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation 2002;106:3143-421.
  10. Lloyd-Jones DM, Morris PB, Ballantyne CM, et al. 2017 Focused Update of the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk, A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol 2017 Aug 30 [Epub ahead of print].
  11. AIM-HIGH Investigators. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med 2011;365:2255-67. https://doi.org/10.1056/NEJMoa1107579
  12. Koren MJ, Hunninghake DB. Clinical outcomes in managed-care patients with coronary heart disease treated aggressively in lipid-lowering disease management clinics: the alliance study. J Am Coll Cardiol 2004;44:1772-9.
  13. Carreras ET, Polk DM. Dyslipidemia: Current Therapies and Guidelines for Treatment. US Cardiology Review 2017;11(1):10-5.
  14. Robinson JG, Farnier M, Krempf M, et al. Efficacy and safety of alirocumab in reducing lipids and cardiovascular events. N Engl J Med 2015;372:1489-99. https://doi.org/10.1056/NEJMoa1501031
  15. Cannon CP, Blazing MA, Giugliano RP, et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med 2015;372:2387-97. https://doi.org/10.1056/NEJMoa1410489
  16. Gencer B, Lambert G, Mach F. PCSK9 inhibitors. Swiss Med Wkly. 2015;145:w14094.
  17. Sabatine MS, Giugliano RP, Keech AC, et al. FOURIER Steering Committee and Investigators. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med 2017;376:1713-22. https://doi.org/10.1056/NEJMoa1615664
  18. Ridker PM, Revkin J, Amarenco P, et al. SPIRE Cardiovascular Outcome Investigators. Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients. N Engl J Med 2017;376:1527-39. https://doi.org/10.1056/NEJMoa1701488

Cited by

  1. 오미자 부탄올 분획물이 고지혈증이 유도된 생쥐의 지질대사 및 간조직 유전자 발현에 미치는 영향 vol.39, pp.6, 2017, https://doi.org/10.22246/jikm.2018.39.6.1225
  2. 발효유의 혈중 콜레스테롤 조절 기능과 발효유 기능성에 대한 장내 균총 구성의 영향 vol.37, pp.1, 2019, https://doi.org/10.22424/jmsb.2019.37.1.27
  3. Low-density lipoprotein cholesterol goal attainment rates in high-risk patients with cardiovascular diseases and diabetes mellitus in Korea: a retrospective cohort study vol.19, pp.1, 2017, https://doi.org/10.1186/s12944-019-1158-5