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New guidelines in cardio care

MANILA, Philippines - Philippine heart doctors received practice guidelines from European cardiology experts at the 17th joint annual convention of the Philippine Society of Hypertension and Philippine Lipid and Atherosclerosis Society held recently at the Crowne Plaza Hotel. Global healthcare leader MSD invited guest speaker Alberico Catapano, chairperson of the European Atherosclerosis Society (EAS), to deliver a lecture on the topic “New Advances in Cardiovascular Risk Reduction in High-Risk Patients.”

Professor Catapano, who is also affiliated with the Department of Pharmacological Science at the University of Milan, presented a new set of treatment strategies drafted by the EAS and the European Society of Cardiology (ESC). The guidelines were developed for the management of dyslipidaemias as an integral part of cardiovascular disease prevention. Dyslipidaemia is a spectrum of coronary afflictions that includes the condition of having high levels of bad cholesterol (low-density lipoprotein/LDL) and decreased amounts of good cholesterol (high-density lipoprotein/HDL) in the blood.

Cardiovascular illness, due to thickened arteries from lipid accumulation, is reported to be one of the leading causes of premature mortality and disability in Europe and in other parts of the world, including the Philippines. More than 60 percent of the global burden of coronary heart disease occurs in developing countries, and ill-health, disability, or early death resulting from the illness is projected to rise to 82 million by 2020. In the Philippines, the incidence of cardiovascular disease, as well as the prevalence of established risk factors, such as high cholesterol and increased LDL levels, is increasing.  

As presented by Catapano, the EAS/ESC guidelines cover areas which include approaches in pharmacological treatments and advice concerning dyslipidaemia in elderly, patients with diabetes and transplant patients, among others. The guidelines also offer risk estimation charts and summaries of recommended goals on lipid-lowering therapy, and mention that LDL cholesterol remains as the primary treatment target. 

A section on medicines affecting high-density lipoprotein explains that “raising of HDL-C may be considered as a secondary and optional target in patients with dyslipidaemias.” Among existing treatments that raise good cholesterol levels, niacin has been shown to give the best percentage of increase in HDL, resulting in reduced cases of cholesterol-related cardiovascular disease, although the guideline notes that “the adverse effect of flushing may affect compliance.” In order to address this, laropiprant has been added to an extended release formulation of niacin which raises HDL-C and brings down triglyceride levels, while reducing the flushing caused by niacin.

For patients complying with multiple drug therapies, the EAS/ESC guidelines advise doctors to simplify dosing recommendations if possible by reducing daily doses and concomitant medications, to explore affordable options, and to work the treatment around the patient’s lifestyle and needs. When patients seeking therapy are involved in the treatment, they have a chance of getting the best benefits from the medical regimen.

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Despite available therapeutic remedies for lowering cholesterol, the health goals of many patients remain off-target, and one of the reasons could be the suboptimal use of lipid-lowering agents. It is important to remember that management of lipid levels is an essential and integral part of cardiovascular disease prevention.

MSD remains committed to the continuous advancement in the research and development of medicines for cardiovascular diseases and other unmet medical needs to improve the quality of life of patients. It is also MSD’s goal to help in the continuing medical education of physicians so that they can in turn give better care to their patients. Talk to your doctor about available options to reduce your risk of cardiovascular diseases.

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