Robinson - Figure 4 - Recommendation #2
The FNLA’s second recommendation is that
- almost all FH patients will require a regimen of adequate therapy with a
lipid-modifying drug in order to achieve effective CVD risk reduction
- specifically, if, after a period of lifestyle modifications (which should never
exceed 3 months), the patient’s LDL cholesterol level remains >190 mg/dL, then
those patients should begin drug therapy with a statin as the evidence-based drug
of choice for long-term prevention of CHD.
All adult FH patients should receive statin therapy, with a dose of the prescribed statin
that should lower serum LDL cholesterol by at least 50%. This would mean, of course,
that if that patient’s baseline LDL cholesterol was 300 mg/dL, then the on-treatment LDL
would be 150 mg/dL – which is still a level associated with substantially increased CHD
risk. As a result, further intensification of lipid-lowering treatment may be considered
– but as a first, policy-based step, physicians really should strive for a 50% serum LDL
cholesterol reduction.
Robinson J.
J Clin Lipidol.
2011; 5(6).
