Cardiovascular disease was the most common cause of death worldwide from 2015 to 2020. Cardiovascular disease refers to diseases that occur in major arteries such as cardiovascular, cerebrovascular, and peripheral blood vessels. Risk factors for these cardiovascular diseases include age (male > 45 years, female > 55 years), family history of early onset of coronary artery disease, Hypertension, smoking, dyslipidemia (low HDL-chol), etc. Today, we are going to look at the management of dyslipidemia among these risk factors.
Lipid is a component of cell membranes in our body and is involved in the absorption of fat and fat-soluble vitamins and is a component necessary for the production of various endogenous hormones. cause it to cause Therefore, proper management of these lipids can be an important goal to prevent cardiovascular complications.
According to the 2020 National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention (KCDC), about 45% of men and 38% of women have dyslipidemia among the adult population in Korea. is known
Then, what should be done for the management of such dyslipidemia? According to the guidelines of the Korean Society of Lipid and Arteriosclerosis for dyslipidemia, it is important to first evaluate the cardiovascular risk in order to establish a treatment policy. It is recommended to treat with a different setting.
The ultra-high risk group includes coronary artery disease, atherosclerotic ischemic stroke and transient ischemic stroke, and peripheral vascular disease, and it is recommended to control LDL-C to 70 mg/dl or less. High-risk groups include carotid artery disease, abdominal aneurysm, diabetes, etc., and LDL-C should be controlled to 100 mg/dl or less.
Moderate-risk group refers to those with two or more risk factors for cardiovascular disease listed above, and it is recommended to control LDL-C to 130 mg/dl or less. For drug treatment, a statin, a powerful anti-lipid drug, is recommended first, and if the target LDL-C is not reached, administration of the maximum dose of statin is recommended as long as there are no side effects.
However, if control is not possible, it is recommended to add ezetimibe, an anti-lipid drug that inhibits lipid absorption in the intestine, or to use a PCSK9 inhibitor, a drug recently developed as an injection.
In the case of statins, a representative anti-lipid drug, initially, it was thought that there would be many side effects when used at high doses, so it was recommended to use at the minimum dose that can achieve the target value. It has been proven that the lower the dose, the lower the risk of cardiovascular complications, so it is currently recommended to use the maximum dose without side effects.
The guidelines of the American Heart Association in 2021 also recommend the use of statins with moderate or higher effects in drug treatment of dyslipidemia for primary prevention of cardiovascular disease. We recommend that you use it as much as possible.
‘The lower, the better’ seems to be the most appropriate word to indicate the current age of dyslipidemia treatment.