Future Considerations for the Management of Hyperlipidemia

EP: 1.Unmet Needs in the Management of Patients with Hyperlipidemia

EP: 2.Target LDL-C Levels for Patients

EP: 3.Guideline Recommendations for LDL-C Management

EP: 4.Weighing the Benefits and Risks of Statin Therapy

EP: 5.Important Treatment Considerations With LDL-C– Lowering Therapies

EP: 6.Effective Approaches for Utilizing Nonstatin Therapies

EP: 7.Mechanisms of Action of Nonstatin Therapies

EP: 8.Cost and Safety of Novel, Nonstatin Therapies

EP: 9.Clinical Value of Nonstatin Therapies

EP: 10.Deciding Between Novel, Nonstatin Therapies

EP: 11.Optimizing Treatment of Patients on LDL-C–Lowering Therapies

EP: 12.Identifying Nonadherence in Patients With Hyperlipidemia

EP: 13.Patient Education for LDL-C–Lowering Therapies

EP: 14.Monitoring Patients for Adverse Events and Optimizing Access to Therapies

EP: 15.Additional Considerations for LDL-C–Lowering Therapies

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EP: 16.Future Considerations for the Management of Hyperlipidemia

Anticipated Impacts of Updated Cholesterol Guidelines on Clinical Practice

Key Considerations for Physicians

The upcoming cholesterol guideline updates are likely to significantly impact clinical practice in several ways:

• Evolving LDL-C target levels: Expect potential lowering of target LDL-C levels, especially for highest-risk patients, possibly below the current 70 mg/dL or 55 mg/dL thresholds
• Risk stratification refinement: New guidelines may introduce more nuanced risk assessment tools that better identify patients who would benefit most from intensive lipid-lowering therapy
• Integration with cardiovascular-kidney-metabolic health(CKM) framework: The CKM paradigm will likely influence cholesterol management by:
  • Promoting more comprehensive patient evaluation beyond traditional atherosclerotic cardiovascular disease risk factors
  • Recognizing kidney disease and metabolic disorders as critical risk enhancers
  • Suggesting differential treatment approaches for patients with diabetes, chronic kidney disease, or metabolic syndrome
• Expanded role of nonstatin therapies: Updated guidelines may provide clearer recommendations for sequencing therapies, including earlier consideration of PCSK9 inhibitors and ezetimibe for high-risk patients
• Greater emphasis on residual risk: More attention to addressing residual cardiovascular risk despite achieving LDL-C target levels, potentially incorporating inflammation markers and other lipid parameters

Conclusion

These anticipated changes will require physicians to adopt more personalized approaches to cholesterol management that consider the interconnected nature of cardiovascular, kidney, and metabolic health.