Blood lipid treatment needs to control the target value
Risk Factors | LDL-C（mmol/L） | Non-HDL-C（mmol/L） |
low risk, medium risk | <3.4 | <4.1 |
High Risk | <2.6 | <3.4 |
Very High Risk | <1.8 | <2.6 |
Key Points
lIntervention targets for lipid-lowering therapy
LDL-C is the primary target (class I recommendation, level of evidence A), and non-HDL-C is added as a secondary target (class II recommendation, level of evidence B). The establishment of this secondary target is particularly important for people with elevated triglyceride (TG) levels (such as metabolic syndrome/diabetes etc). Yicare Lipid Meter
lStrategies for lipid regulation
The results of multiple large-scale clinical trials have consistently shown that in order to achieve the core goal of reducing ASCVD primary and secondary risk, statins should be the first choice (class I recommendation, level of evidence A). Then the average LDL-C baseline level of the Chinese population is lower than that of the European and American populations, and there is no data on the safety of high-intensity statin therapy in the Chinese population. Therefore, the application of statins should be started with moderate-intensity doses, according to individual lipid-lowering efficacy. and tolerance situation, adjust the dose appropriately, and finally achieve the clinical target of the primary and secondary targets; if the target cannot be reached, the cholesterol absorption inhibitor-ezetimibe should be used in combination (class I recommendation, level of evidence B), Get a safe and effective fat-regulating effect. Yicare Lipid Meter
lTreatment principles for other types of dyslipidemia
For those with elevated serum TG levels, it is recommended to take non-drug interventions first. If TG levels are only mildly or moderately elevated, ranging from 2.3 to 5.6 mmol/L (200 - 500 mg/dl), in order to prevent and control the occurrence of ASCVD The main goal is to reduce LDL-C levels. Therefore, statins are still the first choice for initiating drug therapy. If non-HDL-C is still not up to standard after non-drug interventions and statin therapy, fibrates or high-purity fish oil preparations can be added to statins.
For patients with severe hypertriglyceridemia, that is, when fasting TG > 5.7 mmol/L (500 mg/dl), the use of drugs that mainly lower TG and very low-density lipoprotein cholesterol levels should be considered first, including fibrates, high Pure fish oil preparation or niacin.
For those with HDL-C<1.0mmol/L (40mg/dl), diet control and lifestyle improvement are advocated, and there is currently no sufficient evidence for drug intervention.
llifestyle intervention
Diet therapy and lifestyle improvement are the basic measures for the treatment of dyslipidemia. Regardless of whether drug intervention is initiated, diet control and lifestyle improvements must be adhered to (class I recommendation, level of evidence A)
lTreatment process monitoring
1. For diet and non-drug treatment, review once every 3 to 6 months. To achieve health goals, review once every 6 to 12 months, and once a year for long-term compliance.
2. Those who take lipid-lowering drugs for the first time should review within 6 weeks. If the standard is met, it will be reviewed once every 6 to 12 months. If the standard is not met, it will be monitored every 3 months.
3. ASCVD patients and their high-risk groups should be tested for blood lipids every 3-6 months.
4. In hospitalized patients with ASCVD, blood lipids should be detected at the time of admission or within 24 hours of admission.
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Four items (total cholesterol, triglyceride, high density, low density) monitoring in one drop of blood, high availability, POC using ergonomic design, capillary whole blood, plasma serum test available, wider test range, blood volume only 25 Microliters, the test time reaches 120 seconds, and the results are quickly obtained. The first choice for blood lipid monitoring, a must for small and medium hospitals!