The 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guidelines on the Management of Blood Cholesterol in Diabetes

• Published in: Diabetes care Vol. 43; no. 8; pp. 1673 - 1678
• Main Authors: Goldberg, Ronald B., Stone, Neil J., Grundy, Scott M.
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.08.2020
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; American Heart Association; Arteriosclerosis; Atherosclerosis; Atherosclerosis - blood; Atherosclerosis - prevention & control; Cardiology; Cardiology - organization & administration; Cardiology - standards; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - prevention & control; Cholesterol; Cholesterol, LDL - blood; Cholesterol, LDL - drug effects; Clinical practice guidelines; Diabetes; Diabetes mellitus; Diabetes Mellitus - blood; Diabetes Mellitus - drug therapy; Diabetes Mellitus - epidemiology; Diabetic Angiopathies - blood; Diabetic Angiopathies - prevention & control; Geriatrics - organization & administration; Geriatrics - standards; Guidelines; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Hypercholesterolemia - epidemiology; Hypertriglyceridemia - blood; Hypertriglyceridemia - drug therapy; Hypertriglyceridemia - epidemiology; Kexin; Low density lipoprotein; Middle Aged; Nursing - organization & administration; Nursing - standards; Pharmacists - organization & administration; Pharmacists - standards; Primary Prevention - organization & administration; Primary Prevention - standards; Proliferating cell nuclear antigen; Risk; Risk Assessment; Risk Factors; Societies, Medical - standards; Statins; Subtilisin; Therapy; United States - epidemiology; United States
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dci19-0036

The American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines recently published its 2018 recommendations on management of LDL cholesterol (LDL-C) in people with diabetes. For primary prevention, moderate-intensity statin therapy is recommended for those aged 40–75 years, with a preference for high-intensity statin treatment for older subjects and for those with higher estimated risk or risk-enhancing factors following a patient-clinician discussion. Statin therapy may be reasonable in adults <40 years or >75 years of age where there is less evidence for benefit. For people with diabetes and established atherosclerotic cardiovascular disease, high-intensity statin therapy is recommended. The majority of these subjects have very high risk, and an LDL-C goal of <70 mg/dL is recommended. If this target is not achieved, ezetimibe and/or a proprotein convertase subtilisin/kexin type 9 inhibitor may be added.