The Living Guidelines: Chronic Stable Angina Pectoris Recommendations for LDL-C, HDL-C and Triglycerides Management Suggest Revisions to the CLASS I Guidelines

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Class I Guidelines

 * 1) LDL-C should be <100 mg/dL Class I (Level of Evidence: A)
 * 2) If baseline LDL-C is ≥100 mg/dL, LDL lowering drug therapy should be initiated in addition to therapeutic lifestyle changes. When LDL-lowering medications are used in high risk or moderately high-risk persons, it is recommended that intensity of therapy be sufficient to achieve a 30% to 40% reduction in LDL-C levels. Class I (Level of Evidence: A)
 * 3) If on-treatment LDL-C is ≥100 mg/dL, LDL-lowering drug therapy should be intensified. Class I (Level of Evidence: A)
 * 4) If Triglycerides are 200 to 499 mg/dL, non–HDL-C should be <130 mg/dL (Class I Level of Evidence: B)
 * 5) If Triglycerides are ≥500 mg/dL, therapeutic options to lower the Triglycerides to reduce the risk of pancreatitis are fibrate or niacin; these should be initiated before LDL-C lowering therapy. The goal is to achieve non-HDL-C <130 mg/dL if possible. (Class I Level of Evidence: C)