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New clinical guidelines for cholesterol treatment could be a good thing for both physicians and patients, so long as they are used properly.

Unveiled last month at the American Heart Association’s 2018 meeting, the guidelines are intended to help physicians navigate the treatment of patients with high LDL cholesterol.  They aren’t perfect, as guidelines seldom are. For instance, only one patient participated on the committee responsible for the new guidelines, even though the guidelines will impact the lives of thousands of patients.  

But they are a vast improvement over the current standards, for two primary reasons:



And, for the first time, the guidelines acknowledge the value of innovative PCSK9 inhibitors for certain patients.  Research demonstrates that PCSK9 inhibitors can lower stubborn LDL cholesterol, and recent price decreases could improve their accessibility.

For these reasons, the guidelines are a welcome resource for cardiologists and their patients.  But I’d offer a word of caution. All parties should remember the guidelines are just that—guidelines.  In particular, I’d remind policymakers, health plan officials and physicians that:

Cardiologists are fortunate to have both innovative medicines and, now, clear-headed guidance, at their disposal.  I trust my colleagues and I feel equipped, now as much as ever, to have personalized, contextualized conversations with our patients about health history, risk factors, therapeutic options and an individualized, LDL-lowering treatment plan that works best for them.


Dharmesh Patel, MD, is a cardiologist at Stern Cardiology Foundation in Southaven, MS, whose primary focus is the prevention of heart disease. He also serves as president of the Partnership to Advance Cardiovascular Health (PACH), which seeks to advance public policies and practices that result in accelerated innovation and improved cardiovascular health for heart patients around the world.

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