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European Lipid and Prevention Guidelines

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Dr Ian M Graham, Ireland    28 October 2022

  • Both are worthy and detailed but may be far too complex for general use.
  • Why were the simple communication tools for young people of relative risk and risk age dropped from the prevention guidelines?
  • SCORE2 and SCORE2-OP are to be applauded but are derived from different cohorts and there are some inconsistencies as presented, risk can sometimes fall with increasing age.
  • Three different risk categories by age in the prevention guidelines may help to avoid over-treatment in older persons, but you can go to a lower risk category merely by aging.
  • Are there now incompatibilities with other ESC guidelines such as lipids? YES
  • The approach taken to lifetime risk in the prevention guidelines has been criticized.
  • The concept of using benefits as “extra years of life free from CVD gained with treatment” has never been evaluated as a way to guide treatment decisions. It may be that an early review of the prevention guidelines will be appropriate.
  • At present, the 2019 ESC/EAS lipid guidelines present an approach to lipid management that is simpler, and more evidence-based than the 2021 prevention guidelines.

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