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Cited by 1,173Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsHealth Promotion and Cardiovascular Prevention

2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult

Anderson, Todd J., Grégoire, Jean, Pearson, Glen J., Barry, Arden R., Couture, Patrick, Dawes, Martin, Francis, Gordon A., Genest, Jacques +14 more·2016·Canadian Journal of Cardiology
DOI 10.1016/j.cjca.2016.07.510
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Abstract

Since the publication of the 2012 guidelines new literature has emerged to inform decision-making. The 2016 guidelines primary panel selected a number of clinically relevant questions and has produced updated recommendations, on the basis of important new findings. In subjects with clinical atherosclerosis, abdominal aortic aneurysm, most subjects with diabetes or chronic kidney disease, and those with low-density lipoprotein cholesterol ≥ 5 mmol/L, statin therapy is recommended. For all others, there is an emphasis on risk assessment linked to lipid determination to optimize decision-making. We have recommended nonfasting lipid determination as a suitable alternative to fasting levels. Risk assessment and lipid determination should be considered in individuals older than 40 years of age or in those at increased risk regardless of age. Pharmacotherapy is generally not indicated for those at low Framingham Risk Score (FRS; <10%). A wider range of patients are now eligible for statin therapy in the FRS intermediate risk category (10%-19%) and in those with a high FRS (> 20%). Despite the controversy, we continue to advocate for low-density lipoprotein cholesterol targets for subjects who start therapy. Detailed recommendations are also presented for health behaviour modification that is indicated in all subjects. Finally, recommendation for the use of nonstatin medications is provided. Shared decision-making is vital because there are many areas in which clinical trials do not fully inform practice. The guidelines are meant to be a platform for meaningful conversation between patient and care provider so that individual decisions can be made for risk screening, assessment, and treatment.

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Crossref · 10.1016/j.cjca.2016.07.510

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175 of 175 references verified0 citation errors · 0 not checkable

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  • Nonfasting lipid profiles are now endorsed by several guidelines including those in Europe, the UK, Canada, Brazil, and the US.

    “Nonfasting lipid profiles are now endorsed by several guidelines including those in Europe, the UK, Canada, Brazil, and the US [4][5][6]35,38].”

    From Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM (2020) · cites this paper as [5]

  • Guidelines propose using non-HDLC or apoB as a secondary treatment target in the management of patients with mild-to-moderate hypertriglyceridemia (2-10 mmol/L), including patients with diabetes.

    “Guidelines propose using non-HDLC or apoB as a secondary treatment target in the management of patients with mild-to-moderate hypertriglyceridemia (2-10 mmol/L), including patients with diabetes [4,5].”

    From Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM (2020) · cites this paper as [5]

  • The benefits of the Portfolio dietary pattern have been recognized by major international cardiovascular disease and diabetes clinical practice guidelines, including those of the Canadian Cardiovascular Society, Diabetes Canada, European Atherosclerosis Society, and Heart UK.

    “The benefits of the Portfolio dietary pattern have been recognized by major international CVD and diabetes clinical practice guidelines including those of the Canadian Cardiovascular Society (CCS), 19,20 Diabetes Canada, 21 European Atherosclerosis Society (EAS), 22 and Heart UK, 23,24”

    From Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials (2018) · cites this paper as [19]

  • Because PUFA results for cardiovascular outcomes conflict, some dyslipidemia guidelines advise against PUFA to reduce CVD events while others do not.

    “However, due to conflicting results on the role of PUFA in reduction of CV outcomes (140,141), some dyslipidemia guidelines do not recommend using PUFA to reduce CVD events (142), in contrast to other guidelines (2,7).”

    From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [142]

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Authors
Anderson, T. J., Grégoire, J., Pearson, G. J., Barry, A. R., Couture, P., Dawes, M., Francis, G. A., Genest, J., Grover, S., Gupta, M., Hegele, R. A., Lau, D. C., Leiter, L. A., Lonn, E., Mancini, G. B. J., McPherson, R., Ngui, D., Poirier, P., Sievenpiper, J. L., Stone, J. A., Thanassoulis, G., & Ward, R.
Affiliations
  • University of Calgary (CA)
  • Montreal Heart Institute (CA)
  • University of Alberta (CA)
  • Centre hospitalier de l'Université Laval (CA)
  • University of British Columbia (CA)
  • McGill University Health Centre (CA)
  • Montreal General Hospital (CA)
  • St. Michael's Hospital (CA)
  • Robarts Research Institute (CA)
  • Population Health Research Institute (CA)
  • University of Ottawa (CA)
  • Institut universitaire de cardiologie et de pneumologie de Québec (CA)
  • Alberta Health Services (CA)
Corresponding author
Anderson, Todd J.
ORCID
Venue
Canadian Journal of Cardiology
Publisher
Elsevier BV
Published
2016-11
Volume
32
Issue
11
Pages
1263-1282
ISSN
0828-282X (ISSN-L)
DOI
10.1016/j.cjca.2016.07.510
OpenAlex
W2485118186
Semantic Scholar
3f7eae0b9435801b6ab2e8bfce1a43ef8fed4d0e
Cited by
1,173
References
177
Citations by year
2026: 13 · 2025: 77 · 2024: 161 · 2023: 150 · 2022: 126 · 2021: 143 · 2020: 168 · 2019: 145 · 2018: 107 · 2017: 66 · 2016: 13 · 2013: 2
FWCI
121.46
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Canadian Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
dyslipidemia management, cardiovascular disease prevention, statin therapy, LDL cholesterol targets, Framingham risk score, cardiovascular risk assessment, non-statin lipid-lowering therapy, shared decision-making, diabetes mellitus, chronic kidney disease, abdominal aortic aneurysm, atherosclerosis
MeSH terms
Adult, Hypolipidemic Agents, Cardiovascular Diseases, Diet, Humans, Life Style, Lipids, Mass Screening, Primary Prevention, Stress, Psychological, Health Behavior, Exercise, Smoking Cessation, Coronary Angiography, Aortic Aneurysm, Abdominal, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Diabetes Complications, Dyslipidemias, Atherosclerosis, Renal Insufficiency, Chronic, Vascular Calcification

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