Lipid profile in Polish women following lacto-ovo-vegetarian and vegan diets – preliminary study.

The European Atherosclerosis Society and American College of Cardiology and American Heart Association guidelines have introduced several new recommendations, according to which vegetarian diets are concerned as beneficial for the cardiovascular system. This study was aimed to investigate the lipid profile in 56 healthy Polish young women – 13 vegans, 18 lacto-ovo-vegetarians and 25 omnivores. HDL cholesterol concentrations were higher in the vegans and vegetarians than in the omnivores. LDL cholesterol levels were lower in the vegans than in both other diet groups. The use of a vegetarian – especially vegan – diet in Polish conditions is associated with a favorable lipid profile and may have cardioprotective effects.

Recommendations and Associated Levels of Evidence for Statin Use in Primary Prevention of Cardiovascular Disease: A Comparison at Population Level of the American Heart Association/American College of Cardiology/Multisociety, US Preventive Services Task Force, Department of Veterans Affairs/Department of Defense, Canadian Cardiovascular Society, and European Society of Cardiology/European Atherosclerosis Society Clinical Practice Guidelines

Background: Despite using identical evidence to support practice guidelines for lipid-lowering treatment in primary prevention of cardiovascular disease (CVD), it is unclear to what extent the 2018 American Heart Association/American College of Cardiology/Multisociety, 2016 US Preventive Services Task Force (USPSTF), 2020 Department of Veterans Affairs/Department of Defense, 2021 Canadian Cardiovascular Society, and 2019 European Society of Cardiology/European Atherosclerosis Society guidelines differ in grading and assigning levels of evidence and classes of recommendations (LOE/class) at a population level. Methods: We included 7262 participants, aged 45 to 75 years, without history of CVD from the prospective population-based Rotterdam Study. Per guideline, proportions of the population recommended statin therapy by LOE/class, sensitivity and specificity for CVD events, and numbers needed to treat at 10 years were calculated. Results: Mean age was 61.1 (SD 6.9) years; 58.2% were women. American Heart Association/American College of Cardiology/Multisociety, USPSTF, Department of Veterans Affairs/Department of Defense, Canadian Cardiovascular Society, and European Society of Cardiology/European Atherosclerosis Society strongly recommended statin initiation in respective 59.4%, 40.2%, 45.2%, 73.7%, and 42.1% of the eligible population based on high-quality evidence. Sensitivity for CVD events for treatment recommendations supported with strong LOE/class was 86.3% for American Heart Association/American College of Cardiology/Multisociety (IA or IB), 69.4% for USPSTF (USPSTF-B), 74.5% for Department of Veterans Affairs/Department of Defense (strong for), 93.3% for Canadian Cardiovascular Society (strong), and 66.6% for European Society of Cardiology/European Atherosclerosis Society (IA). Specificity was highest for the USPSTF at 45.3% and lowest for European Society of Cardiology/European Atherosclerosis Society at 10.0%. Estimated numbers needed to treat at 10 years for those with the strongest LOE/class were ranging from 20 to 26 for moderate-intensity and 12 to 16 for high-intensity statins. Conclusions: Sensitivity, specificity, and numbers needed to treat at 10 years for assigned LOE/class varied greatly among 5 CVD prevention guidelines. The level of variability seems to be driven by differences in how the evidence is graded and translated into LOE/class underlying the treatment recommendations by different professional societies. Efforts towards harmonizing evidence grading systems for clinical guidelines in primary prevention of CVD may reduce ambiguity and reinforce updated evidence-based recommendations.

DYSLIPIDEMIA: OVERVIEW OF THE ESC/EAS 2019 RECOMMENDATIONS FOR DIAGNOSTICS AND TREATMENT. PART 2 – TARGET THERAPY

The high incidence of cardiovascular disease leads to a routine individual assessment of the patient's cardiovascular risk, and to the correction of the therapy. In 2019, at the European Congress of Cardiology, updated recommendations of the ESC/EAS (European Society of Cardiology / European Atherosclerosis Society) on the diagnosis and treatment of dyslipidemia were presented, new approaches to cardiovascular risk assessing and correction of dyslipidemia were formulated. The article discusses the main aspects of clinical application of the new recommendations for the treatment of this pathology.

DYSLIPIDEMIA: OVERVIEW OF THE ESC/EAS 2019 RECOMMENDATIONS FOR DIAGNOSTICS AND TREATMENT. PART 1 – RISK ASSESSMENT

The high incidence of cardiovascular disease leads to a routine individual assessment of the patient's cardiovascular risk, and to the correction of therapy. In 2019, at the European Congress of Cardiology, updated recommendations of the ESC/EAS (European Society of Cardiology / European Atherosclerosis Society) on the diagnosis and treatment of dyslipidemia were presented, new approaches to cardiovascular risk assessing and correction of dyslipidemia were formulated. The article discusses the main aspects of clinical use of the new recommendations for the treatment of this pathology.

European Society of Cardiology / European Atherosclerosis Society 2019 Dyslipidemia Treatment Guideline: What Has Changed?

After 3 years, European Society of Cardiology and the European Atherosclerosis Society published the new guideline for the management of dyslipidemias on August 2019. Comparing with the 2016 version, based on the latest prospective studies, randomized trials and Mendelian randomization studies, there are major changes in the recommendations; especially in the areas of total cardiovascular risk estimation, treatment targets and management of treatment, focusing on the combination therapy. Aforementioned studies indicated that it is possible to prevent atherosclerotic cardiovascular diseases by reducing low density lipoprotein cholesterol as early as and as much as possible since there is a correlation between the concentration of low density lipoprotein cholesterol in the blood and the risk of atherosclerotic cardiovascular diseases. In the light of those information the recommendation for patients at very high risk was changed as a low density lipoprotein cholesterol goal of Keywords: dyslipidemia, guidelines, risk assessment, LDL cholesterol