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Lipid Guideline Update

Robert Reilly, MD and Neda Frayha, MD
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Another year, another lipid guideline! The latest ACC/AHA guidelines on managing lipids have quite a few changes from what we’re used to. So, Neda sat down with Dr. Robert Reilly, general internist and Medical Director of The Villages Health, to break down the new recommendations. 

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Ian L., Dr -

In a paper chase August 2018 Andrew Buelt and Joe Weatherly commented on a paper endorsing a strict non meat non dairy plant based diet as a way to slow and even in some cases reverse coronary artery disease in high risk people who had an CAD event .
The paper was by Esselstyn CB et al in the Journal of Family Practice 2014 356-364 .
This stringent vegan diet followed patients over 3.7 years .
It ought be offered as an adjunct to other measures to reduce worrying lipid profiles and high risk CAD .

ralph m. -

If the CAC score is 0, when does it need ti be repeated in a patient between 40 and 75 years old?

Neda F., MD -

Hi Ralph. Here's Bobby's reply: "Ralph brings up a great question. Here is the response I found in the guidelines:
For those patient found to have a CAC score of Zero,”…it is reasonable to withhold statin therapy unless higher-risk conditions, such as cigarette smoking, family history of premature ASCVD, or diabetes mellitus, are present and to reassess coronary artery calcium score in 5 to 10 years” (American College of Cardiology, 2018)"

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Are We Better in the Morning? Full episode audio for MD edition 188:54 min - 88 MB - M4APrimary Care RAP September 2019 Written Summary 580 KB - PDF