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November 2024: Management of blood lipids guidance update
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November 2024: Management of blood lipids guidance update
Management of blood lipids: updated guidance based on NICE guidance NG238
A summary of the updates:
- Baseline measurements and monitoring: HbA1c no longer required at baseline. Check patient’s diabetes status.
- Primary prevention: risk assessment:
- QRISK3
is the current version of the calculator. QRISK2 can be used if QRISK3 is not available. QRISK3 has been updated with indicators for certain patient groups to incorporate disease or medication specific risks of cardiovascular disease (CVD). QRISK3 (on-line version if necessary) should be used for the following patient groups:
- people taking corticosteroids or atypical antipsychotics or people with systemic lupus erythematosus, migraine, severe mental illness (schizophrenia, bipolar disorder or other psychoses), or erectile dysfunction.
- Consider using QRISK3-lifetime to inform discussions on CVD risk and to motivate lifestyle changes particularly for people with a 10-year QRISK3 score less than 10%, and people under 40 who have CVD risk factors.
- QRISK3
is the current version of the calculator. QRISK2 can be used if QRISK3 is not available. QRISK3 has been updated with indicators for certain patient groups to incorporate disease or medication specific risks of cardiovascular disease (CVD). QRISK3 (on-line version if necessary) should be used for the following patient groups:
- Secondary prevention:
- New target lipid level: LDL-C 2.0 mmol/L or less, or non-HDL-C 2.6 mmol/L or less.
- Consider ezetimibe in addition to maximum tolerated intensity and dose of statin to reduce CVD risk further, even if the lipid target for secondary prevention of CVD is met.
See here for the formulary guidance.
