VA/DoD Guidelines on Dyslipidemia Recommend Against Frequent LDL Testing

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Some of the key guidelines on managing dyslipidemia that were recently released by the U.S. Department of Veterans Affairs and Department of Defense are summarized in the Annals of Internal Medicine.

Among the highlights:

• The groups recommend continuing to treat to target statin dose, not LDL cholesterol levels.

• Routine use of coronary artery calcium testing or additional risk markers is not recommended.

• For primary prevention, moderate-dose statins are still emphasized. The groups "strongly recommend against" use of proprotein convertase subtilisin/ kexin type 9 (PCSK9) inhibitors for primary prevention.

• For secondary prevention, moderate-dose statins are recommended as first-line treatment, with stepped intensification in patients at higher risk.

• Nonfasting lipid tests are recommended no more than every 10 years.

• Aerobic activity of any intensity and duration is recommended.

• For both primary and secondary prevention, the groups suggest a Mediterranean diet.