Propuesta personal de actualización para el tratamiento de la hipercolesterolemia en Colombia

Abstract

In 2014, Colombia published guidelines for the diagnosis and treatment of dyslipidemias in adults, which were similar to those published by the American College of Cardiology/American Heart Association (ACC/AHA) with regard to their rigidity in the systematic review of the evidence in hydroxymethylglutaryl coenzyme A inhibitors (statins). The result of the review was to not set goals for the cholesterol contained in very low density lipoproteins (LDLc), but rather a percentage reduction in basal LDLc, using the highest doses of high-intensity statins to accomplish this. This proposal created controversy, and in spite of recognizing the evidence, it was argued that the concept of goals could be deduced from the clinical studies, and would make application to clinical practice easier for physicians and patients. In the last few years, international guidelines on dyslipidemias have emphasized LDLc goals, new clinical studies have been published, and novel hypolipidemic medications have appeared on the market. These findings warrant updating hypercholesterolemia treatment in Colombia, and a personal proposal is presented for this purpose, recognizing that a consensus must be reached. Additionally, the recent findings further confirm the importance of cholesterol as a risk factor for cardiovascular disease, and reaffirm that the lower an individual's cholesterol, the lower the probability of cardiovascular events.