Vnitr Lek 2007, 53(2):181-197

Czech Atherosclerosis Society Guidelines for the Diagnosis and Treatment of Dyslipidemias in Adults

H. Vaverková^1,*, V. Soška², H. Rosolová³, R. Češka⁴, R. Cífková⁵, T. Freiberger⁶, J. Piťha⁷, R. Poledne⁷, T. Štulc⁴, Z. Urbanová⁸, M. Vráblík⁴

¹ III. interní klinika Lékařské fakulty UP a FN Olomouc, přednosta prof. MUDr. Vlastimil Ščudla, CSc.

² Oddělení klinické biochemie FN u sv. Anny v Brně, přednosta doc. MUDr. Vladimír Soška, CSc.

³ Centrum preventivní kardiologie, II. interní klinika Lékařské fakulty UK a FN Plzeň, přednosta doc. MUDr. Jan Filipovský, CSc.

⁴ III. interní klinika 1. lékařské fakulty UK a VFN v Praze, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA

⁵ Pracoviště preventivní kardiologie Institutu klinické a experimentální medicíny, Praha, přednostka doc. MUDr. Renata Cífková, CSc.

⁶ Genetická laboratoř, Centrum kardiovaskulární a transplantační chirurgie, Brno, ředitel prof. MUDr. Jan Černý, CSc.

⁷ Laboratoř pro výzkum aterosklerózy Institutu klinické a experimentální medicíny, Praha, vedoucí MUDr. Jan Piťha, CSc.

⁸ Klinika dětského a dorostového lékařství 1. lékařské fakulty UK a VFN v Praze, přednosta prof. MUDr. Josef Hoza, CSc.

The present guidelines are based on the recommendations published in 2005 entitled "Prevention of Cardiovascular Diseases in Adulthood" summarizing the conclusions of nine Czech medical societies and agree with them in the assessment of individual risks of mortality from cardiovascular disease (CVD) according to SCORE tables. They reflect new research data in pathophysiology of dyslipidemias (DLP) and particularly the results of recent clinical trials of lipid-lowering therapy and their meta-analyses. They establish priorities for the screening and management of DLP, present suitable diagnostic methods, additional investigations of potential use in risk assessment, including some emerging risk factors and detection of sub-clinical atherosclerosis in persons in a moderate-risk category. Major changes include a lower LDL-cholesterol treatment target (< 2.0 mmol/L for all CVD individuals) and a possible use of apolipoprotein B as a secondary target in selected persons (< 0.9 g/L in high risk without CVD, < 0.8 g/L for CVD patients) and nonHDL-cholesterol (< 3.3 mmol/L in high risk without CVD, < 2.8 mmol/L for CVD patients). Therapy of individual DLP phenotypes (monotherapy and combination therapy) as well as basic principles for control examination at lipid-lowering medication are described. Recommended therapeutic lifestyle changes are shown. Enclosed are five annexes: DLP diagnosis; causes of secondary DLP; additional investigations of potential use in risk stratification; familial hypercholesterolemia; list of recommended foods; two variants of SCORE tables for risk assessment for the Czech Republic; the scheme of recommended procedures and treatment algorithm in DLP asymptomatic individuals.

Keywords: dyslipidemias; guidelines; LDL-cholesterol; apolipoprotein B; cardiovascular diseases

Received: January 12, 2007; Published: February 1, 2007  Show citation