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26 Guía de práctica clínica sobre el manejo de los lípidos como factor de riesgo cardiovascular18. When must we begin hypolipemiant treatment in primary prevention in southernEurope?19. What is the most effective hypolipemiant treatment in primary prevention?20. When is it necessary to begin hypolipemiant treatment in secondary prevention?21. What is the most effective hypolipemiant treatment in secondary prevention?22. When is it necessary to begin hypolipemiant treatment in secondary prevention?23. What should the therapeutic approach be to hypertriglyceridemia?24. How should mixed hyerlipidemia be treated?25. What are the conditions for combined hypolipemiant treatment?26. Are functional foods, vitamin supplements and dietary complements efficient inreducing cardiovascular morbimortality in patients with lipid disorder?27. Are medicinal plants effective in reducing cardiovascular morbimortality in patients withlipid disorder?28. When should the lipid profile be requested in the case of children?29. What are the target levels and figures in children?30. What therapeutic measures can be adapted in children with family hypercholesterolemy?
Guía de práctica clínica sobre el manejo de los lípidos como factor de riesgo cardiovascular27Summary of recommendationsCardiovascular risk assessmentBC✔✔✔Use of tables adapted and validated for the population of the Spanish State isrecommended.Use of REGICOR project tables is recommended in the calculation of coronaryrisk in patients without cardiovascular disease.Coronary risk must not be calculated according to the REGICOR project tablesin patients of over 74 years of age, nor in the presence of established vasculardisease, family hypercholesterolemy, genetic dyslipemia or in situations in whichthe total cholesterol level is >320 mg/dl or c-LDL > 240 mg/dl.In the results of clinical analyses, reference to desirable cholesterol figures or tonormality ranges in lipid figures must be avoided as their relevance will dependon the individual situations of patients, such as the presence of cardiovasculardisease, family hypercholesterolemy, combined family hyerlipidemia, previouscase histories of disease in the family or premature cardiovascular mortality or,in their absence, of the coronary risk of patients.New research is required to help establish the nature of the association betweentriglycerides and coronary disease.✔ In the general population, screening with the lipid profile is recommended at 40years of age in men and 45 in women in order to calculate their coronary risk.✔D✔DAs of 40, in the case of patients with low-risk in the initial evaluation by meansof the REGICOR function, the coronary risk calculation must be repeated everyfour years.In patients of over 75 years of age, there is no evidence to support thecalculation of coronary risk.Lipid profiles in patients with previous family case histories of premature vasculardisease or family dyslipemia or obesity must be assessed on an individual basis.In patients with hypertension or diabetes, the lipid profile must form part of theinitial assessment of the individual and must be repeated on an annual basis.
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