00:00The guidelines are points of reference for how to optimize clinical practice and have a view of the future.
00:13So when they are made and published, they have impositions, suggestions that are not easy to reach.
00:22And this creates a disconnect between what should be and what is.
00:29And it takes a while in clinical practice to reach these goals.
00:33In reality, the guidelines always suggest to look at the cardiovascular risk and as far as dyslipidemia is concerned,
00:39in subjects at very high risk, a goal of LDL less than 55 mg per deciliter and 70 for subjects at high risk.
00:48How far are we? We are far, but for many reasons that we will see in a moment.
00:53But above all, because we move on to changes, to the use of drugs, to the new attitudes of doctors, which takes time.
01:00So I would see it as a problem, of course, because it is not optimal for the patient, it is a point to tend to,
01:07but it is also necessary to have a little patience.
01:10The scientific community must be convinced, must begin to apply and have the means to reach these therapeutic goals,
01:17which are not always achievable with the old-fashioned drugs that are currently in use.
01:24I do not believe that the guidelines must be updated.
01:27They are already intensive enough in the treatment that they suggest.
01:33What needs to be updated is the possibility for doctors to reach the goals.
01:38And this can be done in two ways, essentially.
01:40One with an important education, which is often missing, especially in colleagues of general medicine,
01:46but also in specialties, this must be recognized, but also the regulatory framework.
01:52Many of the limits of our ability to achieve these therapeutic goals are linked to the prescribability of drugs,
02:00especially innovative drugs.
02:02There are reasons for this, of course, but these reasons must not exceed the interest of the patient.
02:08So it is very important that there is a continuous dialogue with the authorities
02:11to try to make it possible to access these innovative drugs to reach the therapeutic goals.
02:17And this will facilitate the achievement of the therapeutic goals.
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