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Patient Education for LDL-C–Lowering Therapies

Panelists discuss how patient education should emphasize the importance of low-density lipoprotein cholesterol (LDL-C) management, the benefits and risks of therapy intensification, and how clinicians can navigate the expanding range of LDL-C–lowering agents by considering patient-specific factors such as cardiovascular risk, prior treatments, and cost-effectiveness.

Optimizing LDL-C Management: A Summary for Physicians

Patient Education Key Points

  • Emphasize LDL-C level as a primary modifiable risk factor for cardiovascular disease and the relationship between lower LDL-C levels and improved outcomes
  • Explain the incremental cardiovascular benefit of progressive LDL-C reduction below traditional target levels
  • Present treatment options in a risk-benefit framework that includes proven mortality/morbidity benefits vs potential adverse effects
  • Address common misconceptions about statin therapy and other lipid-lowering medications
  • Use visual aids and simplified risk calculators to improve patient understanding of their personal cardiovascular risk
  • Discuss lifestyle modifications as foundational therapy that enhances medication effectiveness

Treatment Selection Strategies

  • Implement a stepwise approach starting with high-intensity statins as first-line therapy
  • Consider nonstatin therapies (e.g., ezetimibe, PCSK9 inhibitors, and bempedoic acid) based on:
    • Residual risk after maximum-tolerated statin therapy
    • Baseline risk profile (prioritizing highest-risk patients for combination therapy)
    • Prior medication tolerance and response
    • Cost-effectiveness and insurance coverage constraints
  • Personalize treatment intensity based on individual risk factors, comorbidities, and LDL-C reduction target levels
  • Establish clear thresholds for therapy intensification based on risk stratification
  • Develop institution-specific protocols that incorporate cost considerations and local formulary constraints
  • Consider patient preferences and medication adherence factors in therapy selection
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