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[1] Updated for the first time in six years, clinical guidelines for managing cholesterol now recommend earlier screenings. These screenings can start as young as nine years old for those with a family history of heart disease. “Shifting the paradigm towards proactive prevention strategies earlier in life can meaningfully change the trajectory of cardiovascular disease and lead to better health outcomes for people decades later,” Johns Hopkins cardiologist Seth Martin, a member of the guideline writing committee, said in a statement on the Hopkins website. Johns Hopkins is a world-renowned private research university in the US state of Maryland.
[2] The guidelines were introduced at the American College of Cardiology’s annual Scientific Session on March 28. They include a new framework to help doctors calculate personalised risk assessments considering each patient’s underlying conditions. These can include a family history of congested arteries, arthritis, early menopause and several pregnancy-related issues like pre-eclampsia or gestational diabetes.
[3] The guidelines also encourage shared decision-making between doctors and patients. They emphasise reducing blood levels of low-density lipoprotein (LDL), or bad cholesterol, and other fats and lipids at earlier ages. “We know that lower LDL cholesterol levels are better when it comes to reducing the risk of heart attacks, strokes and congestive heart failure,” said Dr Roger S Blumenthal of Johns Hopkins. “We also know that bringing elevated lipids and blood pressure down in young adults supports optimal heart and vascular health throughout a person’s life.”
[4] The guidelines come at a time when one in 10 American adults has tested positive for high blood cholesterol, according to the Centres for Disease Control and Prevention. Specialists believe the actual number of patients suffering from high cholesterol might be one in four adults. High blood cholesterol increases the risk of narrowing or hardening of the arteries, blocking blood flow and increasing the risk of heart attacks and strokes.
[5] Blumenthal said 80 per cent to 90 per cent of a patient’s risk depends on habits that can be changed to support heart-healthy living and keep cholesterol levels within a normal range. These include eating a heart-healthy diet, engaging in regular, brisk physical activity, avoiding tobacco, getting enough sleep and maintaining a healthy weight. He said focusing on lifestyle interventions should be a first or foundational approach.
[6] In addition to screening children with a family history of heart disease, the guidelines recommend that everyone undergo a one-time screening for lipoprotein(a), which can reveal genetic factors that increase an individual’s risk of heart disease by 40 per cent or more. Additional testing can help doctors refine care for each patient.
[7] Based on these guidelines, pregnant or lactating women, adults aged 75 and older and those living with underlying conditions should consult their doctor or cardiologist. This also applies to people undergoing treatment for cancer to ensure their best possible care, according to Johns Hopkins.
Source: Tribune News Service, April 23
