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The new ESC Guidelines dyslipidaemia: the lower the better

Prof. Colin Baigent
ESC 2019

LDL-C levels should be lowered as much as possible to prevent cardiovascular disease, particularly in patients with high and very high risk, according to the 2019 ESC/EAS Guidelines for the management of dyslipidaemia. LDL-C goals have thus been lowered compared with the 2016 Guidelines.

Prof. Colin Baigent (chairperson of the guidelines task force) made it very clear that data take centre stage in the new ESC Guidelines on dyslipidaemia, alongside the categorisation of patients. “Refining the definition of risk was the first step we took, by distinguishing between very high-risk (>10% over 10 years) and high-risk (5-10% risk over 10 years) patients. The emphasis was on a large relative reduction in low-density lipoprotein cholesterol (LDL-C) to achieve a large absolute reduction where possible and to reduce the risk” [1].
“Lower is better in all available trials when it comes to LDL-C,” Prof. Baigent said. “There is now evidence that lowering LDL...

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