New ESC/EAS Guidelines for the management of dyslipidaemias − any controversies behind the consensus?

Very recently and simultaneously in European Heart Journal and Atherosclerosis, the first European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) Guidelines for the management of dyslipidaemias were published.1 One might ask why such guidelines were prepared when the Joint European Guidelines on cardiovascular disease (CVD) prevention published in 2007 already exist covering different CVD risk factors, including dyslipidaemias.2 There were several reasons. One of them was that separate guidelines on hypertension and on diabetes produced jointly by ESC and corresponding European societies were already also published.3,4 Much more important was that there was a need expressed by several societies and many physicians, not only lipidologists, for user-friendly guidelines with improved contents containing most recent data and much more details concerning lipids than existing Joint European Guidelines on CVD prevention. Namely, in the existing Joint European Guidelines on CVD prevention there is, due to space constrains, virtually nothing on familial dyslipidaemias, dietary supplements, or functional foods active on plasma lipid values (plant sterols, red rice, polycosanol, etc.), lipid-lowering drug combinations, management of dyslipidaemias in children, etc. There are also only very few data and almost no recommendations on management of dyslipidaemias in different clinical settings such as diabetes and metabolic syndrome, patients with acute coronary syndrome and those undergoing percutaneous coronary interventions, patients with renal disease, peripheral artery disease, stroke, aortic aneurysm or human immunodeficiency patients. Therefore, after negotiations between two societies, the Task Force was composed and started to write the guidelines in 2009.