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Published on November 15, 2013

New Guidelines Help Physicians Target, Treat Those with High Cholesterol

Physicians are now being advised to treat patients with high cholesterol differently after new guidelines were released this week by the American Heart Association (AHA) and the American College of Cardiology (ACC). The new guidelines suggest using four specific risk factors to determine who and how patients should be treated in order to lower their cholesterol.

The four questions to determine risks are: Do you have heart disease? Do you have diabetes (Type 1 or 2)? Do you have a bad (LDL) cholesterol level of more than 190? Is your 10-year risk of a heart attack greater than 7.5 percent? If physicians determine that the answer is yes to any of the questions, a treatment plan is then developed. Patients who do not meet any of the four criteria should be able to manage their cholesterol levels with lifestyle changes, according to the guidelines.

“The new guidelines are much simpler and are based on randomized trials with high-quality evidence,” said Internal Medicine Physician Madhura Mansabdar, M.D., F.A.C.P., C.P.E., medical director of MidMichigan Health Network. “These guidelines help physicians treat and target patient cholesterol management needs by asking four straight forward questions to better define and develop a treatment plan that includes healthful lifestyle modification with or without statin therapy.”

Statins are drugs that can lower LDL cholesterol levels. The drug works by blocking a liver enzyme needed to make cholesterol. They may also help the body re-absorb cholesterol that has built up in plaques on artery walls, preventing further blockage in blood vessels that could lead to heart and stroke events. Known to be effective in lowering cholesterol, statins may have other potential benefits, such as lowering triglycerides and raising good cholesterol (HDL) levels, however, long-term use is still unknown.

“The new guidelines recommend a patient-centered approach to management of elevated blood cholesterol with recommendations to individualize therapy for persons older than 75 years of age with heart disease, those with potential for drug-to-drug interactions, or a history of intolerance to drug therapy,” said Dr. Mansabdar. “The guidelines continue to emphasize lifestyle modification, such as a heart healthy diet, regular exercise, avoidance of tobacco products, and maintenance of a healthy weight. These are the foundation for good health and reduction of heart disease and stroke.”

Calculating risk factors for heart disease and stroke are part of the Patient Centered Medical Home model of physician practices in which the new cholesterol guidelines questions are regularly addressed. Patient-centered care teams work with patients to keep them healthy. The practice takes ownership for coordinating all of a patient’s medical care and ensuring proper follow-up when a patient needs services outside the practice, such as specialist visits or hospitalization.

Those interested in a referral to a physician may call MidMichigan Health Line at (800) 999-3199.