NEW CRITERIA FOR THE TREATMENT OF LIPID METABOLISM DISORDERS: HIGHLIGHTS OF THE 2025 ESC/EAS RECOMMENDATIONS

Abstract

In 2025 the European Society of Cardiology and the European Atherosclerosis Society updated their 2019 guidelines for the diagnosis and management of dyslipidemia, based on the latest advances in lipid-lowering therapy. Key updates include the introduction of cardiovascular risk assessment using the new SCORE2 and SCORE2-OP algorithms for older adults aged 70 to 89 years and a focus on personalized cardiovascular risk stratification to estimate the 10-year risk of fatal and non-fatal cardiovascular events in patients without established disease; the detection of occult atherosclerosis using imaging methods, with an emphasis on the role of lipoprotein(a) and the earliest possible initiation of combination therapy; the introduction of new drugs to optimally lower low-density lipoprotein cholesterol levels; The focus in dyslipidemia therapy is shifting toward an individualized approach: from the use of bempedoic acid and evinacumab in familial hypercholesterolemia to the targeted use of volanesorsen and icosapentethyl for the treatment of hypertriglyceridemia; the use of statins for primary prevention in HIV infection and anthracycline-induced myocardial dysfunction; the role of omega-3 fatty acids in elderly patients. Particular attention is paid to studying the long-term outcomes of combination therapy to reduce residual risk and a critical analysis of studies on the use of dietary supplements.