Many developments have occurred since the publication of the widely-used
2009 Canadian Cardiovascular Society (CCS) Dyslipidemia guidelines.
Here, we present an updated version of the guidelines, incorporating new
recommendations based on recent findings and harmonizing CCS guidelines
with those from other Societies. The Grading of Recommendations Assessment, Development and Evaluation
(GRADE) system was used, per present standards of the CCS. The total
cardiovascular disease Framingham Risk Score (FRS), modified for a
family history of premature coronary disease, is recommended for risk
assessment. Low-density lipoprotein cholesterol remains the primary
target of therapy. However, non-high density lipoprotein cholesterol has
been added to apolipoprotein B as an alternate target. There is an
increased emphasis on treatment of higher risk patients, including those
with chronic kidney disease and high risk hypertension. The primary
panel has recommended a judicious use of secondary testing for subjects
in whom the need for statin therapy is unclear. Expanded information on
health behaviours is presented and is the backbone of risk reduction in
all subjects. Finally, a systematic approach to statin intolerance is
advocated to maximize appropriate use of lipid-lowering therapy. This
document presents the recommendations and principal conclusions of this
process. Along with associated Supplementary Material that can be
accessed online, this document will be part of a program of knowledge
translation. The goal is to increase the appropriate use of
evidence-based cardiovascular disease event risk assessment in the
management of dyslipidemia as a fundamental means of reducing global
risk in the Canadian population.
Read full article: Canadian Cardiovascular Society Guidelines
Volume 29, Issue 2, February 2013, Pages 151–167
DOI: 10.1016/j.cjca.2012.11.032
