Am Fam Physician. 2024;109(6):583-584
Author disclosure: No relevant financial relationships.
Key Points for Practice
• Using an interactive, online, shared decision-making tool should be considered when counseling patients.
• For patients without CVD, nonfasting lipid testing is recommended only every 5 to 10 years because levels vary minimally over 1 year.
• Nonstatin medications as monotherapy or combined with statins are not recommended for primary prevention.
• In adults older than 75 years, lipid testing or cardiovascular risk calculations should not be performed and statins should not be routinely started for primary prevention.
From the AFP Editors
Cardiovascular disease (CVD) is the leading cause of death globally, and lipid level testing is one aspect of screening to assess risk. Options for testing and treatment have grown complex as more tests and lipid-lowering agents become available. The Canadian PEER group for primary care released guidelines for preventing and managing CVD through lipid management. Acknowledging the many competing demands on family physicians, the guideline considers the “time needed to treat,” meaning the time clinicians spend implementing recommendations.
The guideline is summarized in a two-page reference (https://www.cfp.ca/content/cfp/suppl/2023/10/10/69.10.675.DC1/Figure_1_2-page_Guideline_Summary.pdf) and a free online tool (https://decisionaid.ca/cvd) can facilitate shared decision-making conversations about risks and interventions.
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