Dyslipidemia management in women of reproductive potential: An Expert Clinical Consensus from the National Lipid Association.

Laxmi S Mehta, Kim K Birtcher, Robert Wild, Lynne T Braun, Eugenia Gianos, Karol Watson, Carol F Kirkpatrick, Priyanka Satish, Anandita Agarwala, Dave L Dixon, Erin D Michos, Priyamvada Pillai

Journal: Journal of clinical lipidology 2024;18(5):e664-e684

PMID: 38824114

Full Text on Elsevier Science View on PubMed

Abstract

Cardiovascular disease (CVD) is the leading cause of death among women and its incidence has been increasing recently, particularly among younger women. Across major professional society guidelines, dyslipidemia management remains a central tenet for atherosclerotic CVD prevention for both women and men. Despite this, women, particularly young women, who are candidates for statin therapy are less likely to be treated and less likely to achieve their recommended therapeutic objectives for low-density lipoprotein cholesterol (LDL-C) levels. Elevated LDL-C and triglycerides are the two most common dyslipidemias that should be addressed during pregnancy due to the increased risk for adverse pregnancy outcomes, such as preeclampsia, gestational diabetes mellitus, and pre-term delivery, as well as pancreatitis in the presence of severe hypertriglyceridemia. In this National Lipid Association Expert Clinical Consensus, we review the roles of nutrition, physical activity, and pharmacotherapy as strategies to address elevated levels of LDL-C and/or triglycerides among women of reproductive age. We include a special focus on points to consider during the shared decision-making discussion regarding pharmacotherapy for dyslipidemia during preconception planning, pregnancy, and lactation.

Address: Center for Cardiovascular Disease Prevention Cardiovascular Division, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA (Dr Agarwala). Electronic address: [email protected].; Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA (Dr Dixon); Center for Pharmacy Practice Innovation, Virginia Commonwealth University, Richmond, Virginia, USA (Dr Dixon).; Department of Cardiology, Northwell Health, New Hyde Park, Cardiovascular Institute, Lenox Hill Hospital Northwell, New York, NY, USA (Dr Gianos).; Midwest Biomedical Research, Addison, IL, USA (Dr Kirkpatrick); Kasiska Division of Health Sciences, Idaho State University, Pocatello, ID, USA (Dr Kirkpatrick).; Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore, MD, USA (Dr Michos).; The University of Texas at Austin Dell School of Medicine, Ascension Texas Cardiovascular, Austin, TX, USA (Dr Satish).; University of Houston College of Pharmacy, Houston, TX, USA (Dr Birtcher).; Rush University College of Nursing, Rush Heart Center for Women, Chicago, IL, USA (Dr Braun).; Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA (Dr Pillai).; Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA (Dr Watson).; Oklahoma University Health Sciences Center, Oklahoma City, OK, USA (Dr Wild).; Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA (Dr Mehta).

DOI: 10.1016/j.jacl.2024.05.005

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MeSH Terms: Humans, Female, Dyslipidemias, Pregnancy, Consensus