Primary prevention of CVD: treating dyslipidaemia

Overview

Dyslipidaemia, defined as elevated total or low-density lipoprotein (LDL) cholesterol levels, or low levels of high-density lipoprotein (HDL) cholesterol, is an important risk factor for CHD and stroke (cerebrovascular disease). This review examines the evidence for treatment of dyslipidaemia for primary prevention of CHD. Primary prevention in this context is defined as long-term management of people at increased risk, but with no clinically overt evidence of CVD, such as acute MI, angina, stroke, and PVD, and who have not undergone revascularisation. Most adults at increased risk of CVD have no symptoms or obvious signs, but they may be identified by assessment of their risk factors (see aetiology/risk factors below). We have divided people with no known CVD into 3 groups: low risk (<0.6% annual CHD risk), medium risk (0.6–1.4% annual CHD risk), and high risk (1.5% or more annual CHD risk). Prevention of cerebrovascular events is discussed in detail elsewhere in Clinical Evidence (see review on stroke prevention). In the US, the preferred method to calculate CVD risk would be to use the Framingham risk equations, the best validated method from a US population.[1]

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