When the American Heart Association (AHA) unveiled new cholesterol guidelines last year, it spotlighted certain non-traditional cardiac risk factors for those who may be at increased risk of cardiovascular disease, putting not just patients on task, but their physicians as well.

The influx of home-monitoring devices such as cardiac wearables allow people to take cardiovascular health into their own hands. Free tools like the AHA/American College of Cardiology Risk Calculator can identify the severity of cardiovascular your risk. 

But the most important aspect of ensuring optimal cardiovascular health is having a continued relationship with your physician, especially if you fall into these risk groups. The new guidelines provide the following risk-enhancing factors that make people vulnerable to potential cardiovascular disease:

• Premature menopause and pregnancy-associated conditions like hypertension and preeclampsia
• Primary hypercholesterolemia
• Metabolic syndrome
• Chronic kidney disease
• Chronic infl¬ammatory conditions such as psoriasis, rheumatoid arthritis (RA), Crohn’s disease or human immunode¬ficiency virus (HIV)/acquired immunodefi¬ciency syndrome (AIDS)

The new guidelines pave the way for physicians to remain in data-driven, individualized risk discussions with patients. Direct patient engagement and shared decision-making between patient and physician is essential to better health. The broadened categories and added risk enhancers serve as aids to evaluate cardiovascular risk, then identify who needs treatment — it’s no longer about your good and bad cholesterol numbers (unless you’ve already suffered a heart attack or stroke), it's about a patient’s cardiovascular risk. It's also important to be on the correct intensity statin therapy. You may require a moderate intensity or high-intensity cholesterol lowering drug.

If you are at high cardiovascular risk, you should be on a high-intensity cholesterol lowering drug, which reduces your LDL by more than 50 percent. Moderate-intensity statins typically lower cholesterol by 30-50 percent.

Women, inflammation and cardiovascular disease

There’s a significant gender discrepancy in terms of cholesterol treatment — research has shown approximately 40 percent of women who require cholesterol medication, are not on cholesterol medicine or not on the correct dose. Why? One theory is because most women get their primary care from a gynecologist, who typically isn’t aware of the connection between cardiovascular risk and these new cardiovascular risk enhancing factors. Patient evaluation is not focused on cardiac risk issues, family history of cardiovascular disease or cholesterol panels.

Aside from gender discrepancy, patients with diseases that cause systemic inflammation, such as inflammatory bowel disease, psoriasis metabolic syndrome and rheumatoid arthritis, may seem OK, because their effects are away from the heart. Inflammation always remains a hot topic and can affect your circulation — leading to a potentially catastrophic situation.