Does one treatment plan fit all? The Benefit of Patient-Centered Management of Dyslipidemia

According to the Centers for Disease Control and Prevention (CDC), 71 million American adults have dyslipidemia, or high strongheartcholesterol, with only one in three of them taking the necessary steps to control it.  As this issue greatly impacts our nation, it’s critical that we as clinicians are doing everything we can to understand our patients risk for cardiovascular disease (CVD), specifically coronary heart disease. With heart disease being the leading cause of death in both men and women in the United States, it’s imperative that we are educating our patients on the various ways to prevent and/or manage dyslipidemia.  It’s critical that we are identifying primary and secondary patients who are at risk for heart attacks, strokes and death early on. By identifying those patients we can work together to prevent and/or manage dyslipidemia. There are staggering statistics that show heart attacks and strokes occur every 60 seconds in America. What’s more – during any 30 minute block of time 120 Americans will have a heart attack or stroke and one-third of them will die. That is why it is so crucial to catch the warning signs early in order to prevent one of these life-threatening events from occurring.

Statin Therapy Guidelines

As I’m sure many of you are aware, the American College of Cardiology (ACC) and the American Heart Association (AHA) latest guidelines recommended statin therapy  to manage cholesterol for four groups of people who have or are at a high risk for developing the disease. While these recommendations can be beneficial to some patients, the guidelines only address four types of cases and therapy needs that are based heavily on the use of a statin. Since patient cases vary, I’m a firm believer that we need to establish a “back-to-basics” approach and personalize therapy options to successfully help each unique patient case.

NLA Draft Recommendations

The National Lipid Association (NLA) recently issued draft recommendations for patient-centered management of dyslipidemia.  These recommendations were created by an expert panel looking to add information to the statin therapy guidelines by the ACC and AHA. The draft recommendations outlined the importance of acknowledging risk factors for dyslipidemia including age, gender and family history of cardiovascular disease (CVD). They also highlighted the importance of non-high-density lipoprotein (all of the bad cholesterol) and low-density lipoprotein (which usually approximates 70% of the bad cholesterol) as primary targets for therapy and the need for clinicians to personalize how each patient manages dyslipidemia.

I’m a fan of this proposed approach and hope the recommendations are adopted.  In my practice, I always customize my treatment plan based on the particular patient. What works for one patient, may not always work for the next. The expert panel suggested that clinicians take a personalized approach by counseling patients and catering to their specific needs in order to obtain overall heart health. I find this recommendation to be especially useful as it focuses on patient’s needs on a case-by-case basis as opposed to generalizing all dyslipidemia patients.

When I work with my patients, I start off our first meeting by asking them about their family history, lifestyle, eating habits and acknowledge any other health concerns they may have. Based on their situation, I recommend the VAP® + Lipid Panel, which provides me with an in-depth picture of their potential cardiovascular lipid risks. Once we receive the results from the VAP® + Lipid Panel, I work with the patient to determine what form of treatment will be the most beneficial in lowering their individual risk. We discuss various forms of treatment from medications to lifestyle modifications, such as losing weight, quitting smoking, eating a well-balanced diet and getting necessary exercise, and we determine what will work best to help he or she lessen their risk for CVD. It is important for patients to know their options when looking to control and/or eliminate risk factors that could lead to a life-threatening disease.

The relationship between clinician and patient is essential to the treatment process and overall outcome. I strongly encourage you to use comprehensive lipid testing for your patients to gain a better picture of their CV risk. This will help you customize their specific treatment plans. I hope to see these recommendations come to fruition in the near future as I think our dyslipidemia patients may benefit from more personalized care.


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