A lipidologist perspective of global lipid guidelines and recommendations, part 2: Lipid treatment goals

•Having knowledge of worldwide lipid guidelines and recommendations may provide clinicians a more global perspective on lipid management.•Lipid guidelines and recommendations have significant concordance regarding the need to reduce atherogenic lipoprotein cholesterol levels and are in general agreement on the primary lipid treatment targets.•Evidence based on epidemiologic data and clinical outcomes studies supports lipid treatment goals and a titration strategy to achieve lipid treatment goals.•Finally, a substantial degree of agreement exists among guidelines and recommendations in their emphasis on the need for aggressive treatment of hypercholesterolemia, with statins being the first-line treatment of choice.

Having knowledge of worldwide areas of harmonization and consensus regarding lipid guidelines and recommendations may provide clinicians a more global perspective on lipid management. This review examines 8 international scientific/medical organizations that have issued lipid guidelines, recommendations, and position papers: the National Lipid Association (2014), National Institute for Health and Care Excellence (2014), International Atherosclerosis Society (2013), American College of Cardiology/American Heart Association (2013), Canadian Cardiovascular Society (2013), Japan Atherosclerosis Society (2012), European Society of Cardiology/European Atherosclerosis Society (2012), and Adult Treatment Panel III (2001/2004). Part 1 of this perspective focused on sentinel components of these lipid guidelines and recommendations as applied to the role of atherogenic lipoprotein cholesterol levels, primary lipid target of therapy, other primary and secondary lipid treatment targets, and assessment of atherosclerotic cardiovascular disease (ASCVD) risk. This part 2 examines goals of lipid-altering therapy. While lipid guidelines and recommendations may differ regarding ASCVD risk assessment and lipid treatment goals, lipid guidelines and recommendations generally agree on the need to reduce atherogenic lipoprotein cholesterol levels, with statins being the first-line treatment of choice.