January 9, 2019
The American Heart Association / American College of Cardiology (AHA/ACC) Task Force recently published the 2018 Guideline on the Management of Blood Cholesterol. The guidelines writing committee had representation from 12 organizations, including the National Lipid Association, American Diabetes Association, and the American Pharmacists Association — all of whom endorsed the guidelines. The previous guidelines (published in 2013) were intended to answer some specific clinical questions and significantly changed our approach to treatment. The 2018 guidelines provide a more comprehensive set of recommendations, akin to the (older) National Heart, Lung, and Blood Institute Adult Treatment Panel (ATP) III guidelines last published in 2002!
Guest Authors: Dawn Fuke, Pharm.D., BCPS, and Zach Conroy, PharmD, BCACP
Music by Good Talk
October 26, 2018
There has been significant debate regarding the safety of achieving very low LDL-C levels, including a potential negative impact on cognitive function. The current ACC/AHA guidelines (circa 2013) suggest decreasing the statin dose in patients with two consecutive LDL-C levels below 40 mg/dL based on expert opinion. The lack of evidence has been a major challenge for clinicians and it is unclear whether medication doses should be reduced in high-risk patients who may benefit from very low LDL-C levels. A recently published meta-analysis sought to address this clinical dilemma.
Podcast Case: Very Low LDL Case
Guest Authors: Apryl Anderson, PharmD and Dave Dixon, PharmD, BCPS, BCACP, CLS, CDE
Music by Good Talk
August 25, 2017
Statins reduce atherosclerotic cardiovascular disease (ASCVD) risk. However, the utility of statin therapy in older adults — particularly in those age 75 years and older — remains controversial. The need for additional evidence to guide clinical practice is underscored by the fact that one-in-three older Americans report taking a statin. Given the paucity of prospective data, a post-hoc analysis of the ALLHAT-LLT (Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial - Lipid Lowering Trial) was recently published. Does this new analysis really help inform the decision?
Guest Author: Leo Buckley, Pharm.D.
Music by Good Talk
September 15, 2016
The HOPE-3 trial sought to determine if blood pressure (BP) and cholesterol-lowering therapies are effective and safe as primary prevention strategies in intermediate risk patients. The American College of Cardiology and American Heart Association (ACC/AHA) guidelines support a risk-based approach to statin use but in intermediate risk patients the tradeoffs between benefit and risk were deemed “less clear.” Do the results of HOPE-3 trial provide enough evidence to support routinely treating intermediate risk patients?
September 5, 2015
Two new mAbs, alirocumab and
evolocumab, have been approved to treat elevated cholesterol when
added to maximally tolerated statin therapy in patients with familial
hypercholesterolemia or history of atherosclerotic cardiovascular disease
(ASCVD). This new class of drugs, the proprotein convertase subtilisin/kexin
type 9 (PCSK9) inhibitors, is considered to be the biggest breakthrough in
cholesterol treatment since statins were approved 3 decades ago. But are they
July 28, 2015
How well do cardiovascular disease risk calculators really perform? Do they over or underestimate risk? Should we rely on them to make treatment decisions?
February 16, 2015
Guidelines promote the use of statins as first line therapy to prevent atherosclerotic cardiovascular disease
events. Does adding niacin to
statin treatment reduce residual risk?