#lipid #gdl
Management of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2020 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline 2020
• 治療目標是預後(心血管疾病、健康、住院、死亡),而不是血脂濃度。
• 血脂(膽固醇、LDL-C、HDL-C、TG):每 10 年檢驗一次,不需要禁食。
• 初級預防:中度劑量的 statins,不要用 PCSK9 抑制劑。高危險群者能加上地中海飲食。
• 次級預防:中度劑量的 statins,高危險群(AMI 之後、ACS 一年內、復發性 AMI/ACS/中風、糖尿病、抽煙、PAOD、PCI、CABG)病人可以用高強度 statins、加上 ezetimibe/PCSK9 抑制劑、禁食 TG > 150 mg/dL(非禁食 TG > 200 mg/dL)者能加上 VASCEPA(Icosapent Ethyl)、地中海飲食。
• 沒有幫助:CAC、CRP、ABI、apolipoproteins。
• 不要用 niacin、fibrates。
Lipitor (atorvastatin 10-20 mg/tablet), Crestor (rosuvastatin 10 mg/tablet).
1. Continue to Treat to Target Dose Not LDL-C Level
2. Use of Additional Tests to Refine Risk Prediction: Evidence Is Still Insufficient
coronary artery calcium (CAC), high-sensitivity C-reactive protein, ankle–brachial index, and apolipoprotein
3. Primary Prevention: Moderate-Dose Statin Therapy Is Still Emphasized; No to Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors
No RCT directly compared high-dose with moderate-dose statin therapy in primary prevention.
4. Secondary Prevention: Moderate Statin Doses Initially, Then Stepped Intensification in Higher-Risk Patients
For higher-risk patients (recent MI or acute coronary syndrome (in the past 12 months); recurrent acute coronary syndrome, MI, or stroke; or established CVD with additional major risk factors (such as current tobacco use, diabetes, peripheral artery disease, or previous coronary artery bypass graft surgery or percutaneous coronary intervention), evidence supports the addition of ezetimibe or PCSK9 inhibitors to moderate- or high-dose statin therapy.
5. Laboratory Testing: No Routine Fasting or Monitoring Is Needed; Less Is More
We recommend measuring lipid levels no more than every 10 years. Note that previously measured lipid levels may be used reliably in serial CVD risk assessments. We do not recommend rechecking lipid levels each time CVD risk is assessed, because lipid levels remain stable within each patient over time and contribute little to predicted risk relative to other factors.
6. Physical Activity: Increased Aerobic Exercise for All and Cardiac Rehabilitation After a Recent CVD Event
7. Nutrition, Supplements, Niacin, and Fibrates: Suggest a Mediterranean Diet for High-Risk Patients, Limit Icosapent Ethyl to Secondary Prevention, Avoid Supplements and Niacin, and Avoid Adding Fibrates to Statin Therapy
https://www.acpjournals.org/doi/full/10.7326/M20-4648
mediterranean diet guideline 在 Coach Anuar Facebook 的最讚貼文
Biasanya, orang yang nak kurus ni dah cuba macam - macam diet. Diet Atkin la, buat Mediterranean la tapi tak juga kurusnya. Silap - silap makin naik lagi ada la. Diet 365hari sepjg tahun dok diet tp xdak hasil kan
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mediterranean diet guideline 在 Coach Anuar Facebook 的精選貼文
Biasanya, orang yang nak kurus ni dah cuba macam - macam diet. Diet Atkin la, buat Mediterranean la tapi tak juga kurusnya. Silap - silap makin naik lagi ada la.
.
.
BAGAIMANA MISI KURUS ONLINE PROGRAM DAPAT MEMBANTU ANDA?
.
.
1) Jurulatih Peribadi Berpengalaman & Profesional
2) Pelan Pemakanan Sihat dan Guideline Pemakanan
3) Nutrisi Seimbang Untuk Sarapan dan Makan Malam
4) Tips Senaman
5) Group Support
6) Hadiah Menarik
Slot sangat terhad kepada 20 orang peserta sahaja. Ambil tindakan segera!
Read more bout my Misi Kurus Online Program 👉 http://oneanuar5.wixsite.com/coachanuar
.
KLIK 👉 www.wasap.my/60103874421 dan taip 'online coaching'
mediterranean diet guideline 在 14 Mediterranean Diet Guidelines ideas - Pinterest 的推薦與評價
Sep 7, 2015 - Learn how to follow a healthy Mediterranean Diet . See more ideas about healthy, mediterranean diet, diet. ... <看更多>