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European Heart Journal Advance Access originally published online on June 21, 2005
European Heart Journal 2005 26(21):2224-2231; doi:10.1093/eurheartj/ehi373
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Lipids and CVD management: towards a global consensus

Christie Ballantyne1, Bruce Arroll2 and James Shepherd3,*

1Arteriosclerosis and Lipoprotein Section, Baylor College of Medicine, Houston, TX, USA
2Department of General Practice and Primary Care, University of Auckland, Auckland, New Zealand
3Department of Pathological Biochemistry, Royal Infirmary, Glasgow G4 0SF, Scotland, UK

Received 13 October 2004; revised 18 April 2005; accepted 19 May 2005; online publish-ahead-of-print 21 June 2005.

* Corresponding author. Tel: +44 141 552 0689; fax: +44 141 553 1703. E-mail address: jshepherd{at}gri-biochem.org.uk

Cardiovascular disease (CVD) is currently the leading cause of morbidity and mortality worldwide and its incidence is likely to increase. Multiple risk factors contribute to CVD. Elevated LDL-cholesterol (LDL-C) and triglyceride levels, low HDL-cholesterol levels, hypertension, type 2 diabetes, and smoking are key modifiable risk factors. Such risk factors are present in 80–90% of coronary heart disease (CHD) patients. For many factors, modification can significantly reduce CVD incidence. For example, statin-induced LDL-C reductions reduce cardiovascular events by 24–37% and smoking cessation reduces CHD mortality by 36%. The need to identify and treat these risk factors has led many national and local groups to develop clinical practice guidelines for management of CVD. Although the aim of such guidelines is to provide practitioners with a framework to identify, prioritize, and manage patients, the plethora of guidelines can cause confusion. In addition, research indicates that guidelines are not being optimally implemented. This review considers these practical issues, highlights the common goals shared by many guidelines, and focuses on how these can be best achieved. It also highlights areas where the guidelines differ and discusses points to consider when selecting the most appropriate recommendation.

Key Words: Guidelines • Cardiovascular disease • Cholesterol • Statin


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