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REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #9 2025

analogues could potentially lower the risk for cardiovascular
disease by 13%–22%, 16%–35%, and 6%–17%, respectively. CLINICAL PEARLS FROM THE FACULTY Dyslipidaemia

Beyond their initial target indications, further research is needed
to fully understand the metabolic fate of triglycerides after
treatment with these novel drugs and to explore their potential
for other indications within lipoprotein metabolism. The differing
hepatic safety profiles observed also highlight the need for
continued detailed study of their mechanisms and long-term
effects. Overall, these novel drug classes offer a promising new
direction in the management of dyslipidaemia and associated
metabolic disorders, with the potential to significantly expand
treatment choices for several challenging patient groups.
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PROF. SHAWKY DISCUSS THE
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SPECIAL POPULATIONS – HYPERCHOLESTEROLEMIA IN THE ELDERLY

Managing hypercholesterolemia in adults older than 75 years without a history of

atherosclerotic cardiovascular disease: An Expert Clinical Consensus from the
National Lipid Association and the American Geriatrics Society.
Bittner V, et al. J Clin Lipidol. 2025;19(2):215-237.

The National Lipid Association (NLA) has issued several scientific statements on key aspects of the management of lipids and
lipoproteins to prevent cardiovascular disease. The current Expert Clinical Consensus, developed as a collaboration between the
NLA and the American Geriatrics Society (AGS), focuses on the treatment of hypercholesterolemia among individuals older than 75
years without clinically manifest ASCVD. The members of the writing group jointly developed a set of key clinical questions, reviewed
literature, and developed recommendations based on the 2019 Update of the AHA/American College of Cardiology (ACC) rating
system for clinical guidelines. The consensus aims to facilitate improved clinical care by addressing eight key questions regarding
LDL-C association with ASCVD, risk assessment,
efficacy and safety of statins, net benefit assessment, NNT for primary prevention for MI and ASCVD by age
shared decision-making, deprescribing, and the role of
non-statin therapies.

The consensus found that despite a natural decrease
in atherogenic lipoprotein levels from early adulthood to
the seventh decade (potentially due to survivor bias or
comorbidities), the association between higher LDL-C
and ASCVD is maintained and remains independent
of age. Contemporary analyses, like the Copenhagen
General Study, revealed that the absolute risk of events
is highest in the oldest age group, and the NNT to
prevent an event (MI or ASCVD) declines with advancing
age. This suggests a greater benefit from LDL-C-
lowering in older compared to younger individuals.

ASCVD, atherosclerotic cardiovascular disease; NNT, number needed to treat.

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