World Heart Federation Cholesterol Roadmap 2022

Primer Autor
Ray, Kausik K.
Co-autores
Ference, Brian A.
Severin, Tania
Blom, Dirk
Nicholls, Stephen J.
Shiba, Mariko H.
Almahmeed, Wael
Alonso, Rodrigo
Daccord, Magdalena
Ezhov, Marat
Olmo, Rosa Fernandez
Jankowski, Piotr
Lanas, Fernando
Mehta, Roopa
Puri, Raman
Wong, Nathan D.
Wood, David
Zhao, Dong
Gidding, Samuel S.
Virani, Salim S.
Lloyd-Jones, Donald
Pinto, Fausto
Perel, Pablo
Santos, Raul D.
Título
World Heart Federation Cholesterol Roadmap 2022
Editorial
UBIQUITY PRESS LTD
Revista
GLOBAL HEART
Lenguaje
en
Resumen
Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipoproteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome.Methods: Through a review of published guidelines and research papers since 2017, and consultation with a committee composed of experts in clinical management of dyslipidaemias and health systems research in low-and-middle income countries (LMICs), this Roadmap identifies (1) key principles to effective ASCVD prevention (2) gaps in implementation of these interventions (knowledge-practice gaps), (3) health system roadblocks to treatment of elevated cholesterol in LMICs, and (4) potential strategies for overcoming these.Results: Reducing the future burden of ASCVD will require diverse approaches throughout the life-course. These include: a greater focus on primordial prevention, availability of affordable cholesterol testing, availability of universal cholesterol screening for inherited dyslipidaemias, risk stratification moving beyond 10-year risk to look at lifetime risk with adequate risk estimators, wider availability of affordable cholesterol-lowering therapies which should include statins as essential medications globally, use of adequate doses of potent statin regimens, and combination therapies with ezetimibe or other therapies in order to attain and maintain robust reductions in LDL-C in those at highest risk. Continuing efforts are needed on health literacy for both the public and healthcare providers, utilising multi-disciplinary teams in healthcare and applications that quantify both ASCVD risk and benefits of treatment as well as increased adherence to therapies.Conclusions: The adverse effects of LDL-cholesterol and apo B containing lipoprotein exposure are cumulative and result in ASCVD. These are preventable by implementation of different strategies, aimed at efficiently tackling atherosclerosis at different stages throughout the human life-course. Preventive strategies should therefore be updated to implement health policy, lifestyle changes and when needed pharmacotherapies earlier with investment in, and a shift in focus towards, early preventive strategies that preserve cardiovascular health rather than treat the consequences of ASCVD.
Tipo de Recurso
artículo original
doi
10.5334/gh.1154
Formato Recurso
PDF
Palabras Claves
cholesterol
low-density lipoprotein cholesterol prevention
ASCVD
lipid lowering therapy
familial hypercholesterolaemia
CARDIOVASCULAR-DISEASE
FAMILIAL HYPERCHOLESTEROLEMIA
LDL-CHOLESTEROL
STATIN THERAPY
RISK-FACTORS
PREVENTION
MANAGEMENT
METAANALYSIS
INDIVIDUALS
EVOLOCUMAB
Ubicación del archivo
http://dx.doi.org/10.5334/gh.1154
Categoría OCDE
Sistemas cardíacos y cardiovasculares
Materias
colesterol
prevención del colesterol con lipoproteínas de baja densidad
ASCVD
terapia hipolipemiante
hipercolesterolemia familiar
ENFERMEDAD CARDIOVASCULAR
HIPERCOLESTEROLEMIA FAMILIAR
COLESTEROL LDL
TERAPIA CON ESTATINA
FACTORES DE RIESGO
PREVENCIÓN
MANEJO
METANALISIS
INDIVIDUAL
EVOLOCUMAB
Disciplinas de la OCDE
Sistema Cardiovascular y Cardiaco
Política de Salud y Servicios
Medicina General e Interna
Título de la cita (Recomendado-único)
World Heart Federation Cholesterol Roadmap 2022
Identificador del recurso (Mandatado-único)
artículo original
Versión del recurso (Recomendado-único)
version publicada
License
CC BY 4.0
Condición de la licencia (Recomendado-repetible)
CC BY 4.0
Derechos de acceso
acceso abierto
Access Rights
acceso abierto
Id de Web of Science
WOS:000874037700001
Colecciones
Colección Publicaciones Científicas
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