Czech Atherosclerosis Society Guidelines for the Diagnosis
and Treatment of Dyslipidemia in Adults
1Vaverková H., 2Soška V., 3Rosolová H., 4Češka R., 5Cífková R., 6Freiberger T., 7Piťha J., 7Poledne R., 4Štulc T., 8Urbanová Z., 4Vráblík M.
1III. interní klinika LF UP a FN, Olomouc 2Oddělení klinické biochemie FN U sv. Anny v Brně 3II. interní klinika, Centrum preventivní kardiologie LF UK a FN, Plzeň 4III. interní klinika 1. LF UK a VFN, Praha 5Pracoviště preventivní kardiologie IKEM, Praha 6Genetická laboratoř, Centrum kardiovaskulární a transplantační chirurgie, Brno 7Laboratoř pro výzkum aterosklerózy IKEM, Praha 8Klinika dětského a dorostového lékařství 1. LF UK, Praha |
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Summary:
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 risk 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.
Key words:
guidelines, dyslipidemias, LDL cholesterol, apolipoprotein B, cardiovascular diseases.
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