{"id":721,"date":"2023-10-26T11:29:18","date_gmt":"2023-10-26T15:29:18","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/rxpidresources\/chapter\/dyslipidemia-3\/"},"modified":"2023-11-10T20:01:02","modified_gmt":"2023-11-11T01:01:02","slug":"dyslipidemia-3","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/rxpidresources\/chapter\/dyslipidemia-3\/","title":{"raw":"Dyslipidemia","rendered":"Dyslipidemia"},"content":{"raw":"
\r\n
In this chapter, you will find Canadian guidelines for the management of dyslipidemia and an article with recommendations on how to manage statin associated adverse drug events . We have also provided you with a scoring tool to determine if your patient requires statin therapy (in the absence of a statin indicated condition).<\/div>\r\n<\/div>\r\n

Student Resources<\/h2>\r\nDyslipidemia One Pager <\/a>\r\n\r\nDyslipidemia Drug Table<\/a>\r\n

Tools<\/h1>\r\n
Framingham Risk Calculator<\/em><\/span><\/summary>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Purpose<\/strong><\/td>\r\nDetermine a patient\u2019s 10 year risk of heart attack in patients without a statin indicated condition ([pb_glossary id=\"56\"]primary prevention[\/pb_glossary]).<\/td>\r\n<\/tr>\r\n
Type of Resource<\/strong><\/td>\r\nScoring tool<\/td>\r\n<\/tr>\r\n
Included<\/strong><\/td>\r\nTool includes risk factors associated with CAD.\r\n\r\nInterpretation of results:\r\n
    \r\n \t
  • <10%: Low risk (statin therapy not recommended)<\/li>\r\n \t
  • 10-19%: Intermediate risk (statin therapy recommended if the following apply<\/span> <\/strong>to your patient)\r\n
      \r\n \t
    • LDL 3.5mmol\/L + OR<\/li>\r\n \t
    • Men aged 50+ y\/o or women aged 60+ y\/o with<\/span> \u2265 1 CV risk factor\r\n
        \r\n \t
      • CV risk factors: Low HDL-C, impaired fasting glucose, elevated waist circumference, cigarette smoking (current or within the last 5 years), hypertension<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
      • 20+%: High risk (statin therapy recommended)<\/strong><\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
Student Bottom Line<\/strong><\/td>\r\nIn patients without a statin indicated condition, use this scoring tool to determine if your patient requires lipid lowering therapy for primary prevention.<\/td>\r\n<\/tr>\r\n
VIEW RESOURCE<\/a><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/details>
UKPDS Cardiac Risk Calculator<\/em><\/span><\/summary>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Purpose<\/strong><\/td>\r\nAssess a diabetic patients 10 year risk of coronary heart disease.<\/td>\r\n<\/tr>\r\n
Type of Resource<\/strong><\/td>\r\nScoring tool<\/td>\r\n<\/tr>\r\n
Included<\/strong><\/td>\r\n\r\n
    \r\n \t
  1. Risk factors associated with CAD in diabetic patients<\/li>\r\n \t
  2. Interpretation of results:<\/li>\r\n<\/ol>\r\n
      \r\n \t
    • High Risk\r\n(Risk Score > 31)\r\nProbability of CHD: > 30%<\/li>\r\n \t
    • Elevated Risk\r\n(Risk Score 18 \u2013 31)\r\nProbability of CHD: 15% to 30%<\/li>\r\n \t
    • Average Risk\r\n(Risk Score < 18)\r\nProbability of CHD: <15%<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
Student Bottom Line<\/strong><\/td>\r\nPrior to starting diabetic patients on statin therapy, use this scoring tool to determine your patients exact risk of CAD.<\/td>\r\n<\/tr>\r\n
VIEW RESOURCE<\/a>\r\n<\/strong><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/details>
The Absolute CVD Risk\/Benefit Calculator<\/em><\/span><\/summary>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Purpose<\/strong><\/td>\r\nDetermine a 10 year risk of cardiovascular related events and relative benefit patients may receive from different drug and non drug intervention.<\/td>\r\n<\/tr>\r\n
Type of Resource<\/strong><\/td>\r\nRisk and benefit calculator<\/td>\r\n<\/tr>\r\n
Included<\/strong><\/td>\r\n\r\n
    \r\n \t
  1. Relative benefit given a certain intervention<\/li>\r\n \t
  2. Baseline risk of CV event<\/li>\r\n<\/ol>\r\n<\/td>\r\n<\/tr>\r\n
Student Bottom Line<\/strong><\/td>\r\nUse this tool to support and explain the benefit to certain pharmacological treatments for patients.<\/td>\r\n<\/tr>\r\n
VIEW RESOURCE<\/a><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/details>\r\n

Guidelines<\/h1>\r\n
The Canadian Cardiovascular Society (CCS) Guidelines<\/em><\/span><\/summary>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Purpose<\/strong><\/td>\r\nGuide treatment recommendations for the management of [pb_glossary id=\"54\"]dyslipidemia[\/pb_glossary]. Includes treatment guidelines specific to primary and secondary prevention.<\/td>\r\n<\/tr>\r\n
Type of Resource<\/strong><\/td>\r\nCanadian guidelines<\/td>\r\n<\/tr>\r\n
Included<\/strong><\/td>\r\n\r\n
    \r\n \t
  1. How to screen for dyslipidemia in at risk patients<\/li>\r\n \t
  2. Management of dyslipidemia for primary and secondary prevention<\/li>\r\n \t
  3. Lipid targets (LDL, non-HDL)<\/li>\r\n \t
  4. Up to date evidence on commonly asked questions<\/li>\r\n<\/ol>\r\n<\/td>\r\n<\/tr>\r\n
Student Bottom Line<\/strong><\/td>\r\nThe recommended resource to guide treatment for patients with statin indicated conditions (secondary prevention) or those at high risk for CV events (primary prevention). For more details and information, the full guidelines are preferred.<\/td>\r\n<\/tr>\r\n
VIEW RESOURCE (full guidelines)<\/a> - VIEW RESOURCE (pocket guidelines)<\/a><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/details>
Prevention and Management of Statin Adverse Events<\/em><\/em><\/span><\/summary>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Purpose<\/strong><\/td>\r\nDetermine how to manage a patient who is experiencing ADRs related to their statin therapy.<\/td>\r\n<\/tr>\r\n
Type of Resource<\/strong><\/td>\r\nArticle recommending an approach on how to manage patients experiencing myalgia.<\/td>\r\n<\/tr>\r\n
Included<\/strong><\/td>\r\n\r\n
    \r\n \t
  1. 6 step approach to determine the best course of action for your individual patient<\/li>\r\n \t
  2. Algorithm with recommendations based on patient CK levels<\/li>\r\n \t
  3. Case examples<\/li>\r\n<\/ol>\r\n<\/td>\r\n<\/tr>\r\n
Student Bottom Line<\/strong><\/td>\r\nIf your patient is complaining of muscle pain secondary to statin therapy, we recommend following this 6 step approach to ensure you make the best recommendation possible for your patient. It is a straightforward and great system to incorporate into your everyday practice.<\/td>\r\n<\/tr>\r\n
VIEW RESOURCE<\/a><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<\/details>","rendered":"
\n
In this chapter, you will find Canadian guidelines for the management of dyslipidemia and an article with recommendations on how to manage statin associated adverse drug events . We have also provided you with a scoring tool to determine if your patient requires statin therapy (in the absence of a statin indicated condition).<\/div>\n<\/div>\n

Student Resources<\/h2>\n

Dyslipidemia One Pager <\/a><\/p>\n

Dyslipidemia Drug Table<\/a><\/p>\n

Tools<\/h1>\n
\nFramingham Risk Calculator<\/em><\/span><\/summary>\n\n\n\n\n\n\n\n
Purpose<\/strong><\/td>\nDetermine a patient\u2019s 10 year risk of heart attack in patients without a statin indicated condition (primary prevention).<\/td>\n<\/tr>\n
Type of Resource<\/strong><\/td>\nScoring tool<\/td>\n<\/tr>\n
Included<\/strong><\/td>\nTool includes risk factors associated with CAD.<\/p>\n

Interpretation of results:<\/p>\n

    \n
  • <10%: Low risk (statin therapy not recommended)<\/li>\n
  • 10-19%: Intermediate risk (statin therapy recommended if the following apply<\/span> <\/strong>to your patient)\n
      \n
    • LDL 3.5mmol\/L + OR<\/li>\n
    • Men aged 50+ y\/o or women aged 60+ y\/o with<\/span> \u2265 1 CV risk factor\n
        \n
      • CV risk factors: Low HDL-C, impaired fasting glucose, elevated waist circumference, cigarette smoking (current or within the last 5 years), hypertension<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n
      • 20+%: High risk (statin therapy recommended)<\/strong><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Student Bottom Line<\/strong><\/td>\nIn patients without a statin indicated condition, use this scoring tool to determine if your patient requires lipid lowering therapy for primary prevention.<\/td>\n<\/tr>\n
VIEW RESOURCE<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details>\n
\nUKPDS Cardiac Risk Calculator<\/em><\/span><\/summary>\n\n\n\n\n\n\n\n
Purpose<\/strong><\/td>\nAssess a diabetic patients 10 year risk of coronary heart disease.<\/td>\n<\/tr>\n
Type of Resource<\/strong><\/td>\nScoring tool<\/td>\n<\/tr>\n
Included<\/strong><\/td>\n\n
    \n
  1. Risk factors associated with CAD in diabetic patients<\/li>\n
  2. Interpretation of results:<\/li>\n<\/ol>\n
      \n
    • High Risk
      \n(Risk Score > 31)
      \nProbability of CHD: > 30%<\/li>\n
    • Elevated Risk
      \n(Risk Score 18 \u2013 31)
      \nProbability of CHD: 15% to 30%<\/li>\n
    • Average Risk
      \n(Risk Score < 18)
      \nProbability of CHD: <15%<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
Student Bottom Line<\/strong><\/td>\nPrior to starting diabetic patients on statin therapy, use this scoring tool to determine your patients exact risk of CAD.<\/td>\n<\/tr>\n
VIEW RESOURCE<\/a>
\n<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details>\n
\nThe Absolute CVD Risk\/Benefit Calculator<\/em><\/span><\/summary>\n\n\n\n\n\n\n\n
Purpose<\/strong><\/td>\nDetermine a 10 year risk of cardiovascular related events and relative benefit patients may receive from different drug and non drug intervention.<\/td>\n<\/tr>\n
Type of Resource<\/strong><\/td>\nRisk and benefit calculator<\/td>\n<\/tr>\n
Included<\/strong><\/td>\n\n
    \n
  1. Relative benefit given a certain intervention<\/li>\n
  2. Baseline risk of CV event<\/li>\n<\/ol>\n<\/td>\n<\/tr>\n
Student Bottom Line<\/strong><\/td>\nUse this tool to support and explain the benefit to certain pharmacological treatments for patients.<\/td>\n<\/tr>\n
VIEW RESOURCE<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details>\n

Guidelines<\/h1>\n
\nThe Canadian Cardiovascular Society (CCS) Guidelines<\/em><\/span><\/summary>\n\n\n\n\n\n\n\n
Purpose<\/strong><\/td>\nGuide treatment recommendations for the management of dyslipidemia. Includes treatment guidelines specific to primary and secondary prevention.<\/td>\n<\/tr>\n
Type of Resource<\/strong><\/td>\nCanadian guidelines<\/td>\n<\/tr>\n
Included<\/strong><\/td>\n\n
    \n
  1. How to screen for dyslipidemia in at risk patients<\/li>\n
  2. Management of dyslipidemia for primary and secondary prevention<\/li>\n
  3. Lipid targets (LDL, non-HDL)<\/li>\n
  4. Up to date evidence on commonly asked questions<\/li>\n<\/ol>\n<\/td>\n<\/tr>\n
Student Bottom Line<\/strong><\/td>\nThe recommended resource to guide treatment for patients with statin indicated conditions (secondary prevention) or those at high risk for CV events (primary prevention). For more details and information, the full guidelines are preferred.<\/td>\n<\/tr>\n
VIEW RESOURCE (full guidelines)<\/a> – VIEW RESOURCE (pocket guidelines)<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details>\n
\nPrevention and Management of Statin Adverse Events<\/em><\/em><\/span><\/summary>\n\n\n\n\n\n\n\n
Purpose<\/strong><\/td>\nDetermine how to manage a patient who is experiencing ADRs related to their statin therapy.<\/td>\n<\/tr>\n
Type of Resource<\/strong><\/td>\nArticle recommending an approach on how to manage patients experiencing myalgia.<\/td>\n<\/tr>\n
Included<\/strong><\/td>\n\n
    \n
  1. 6 step approach to determine the best course of action for your individual patient<\/li>\n
  2. Algorithm with recommendations based on patient CK levels<\/li>\n
  3. Case examples<\/li>\n<\/ol>\n<\/td>\n<\/tr>\n
Student Bottom Line<\/strong><\/td>\nIf your patient is complaining of muscle pain secondary to statin therapy, we recommend following this 6 step approach to ensure you make the best recommendation possible for your patient. It is a straightforward and great system to incorporate into your everyday practice.<\/td>\n<\/tr>\n
VIEW RESOURCE<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/details>\n
definition<\/span>