Skip to main content
Top
Published in: Current Treatment Options in Cardiovascular Medicine 11/2014

01-11-2014 | Prevention (L Sperling and D Gaita, Section Editors)

Practical Implementation of the 2013 AHA/ACC Blood Cholesterol Guidelines

Authors: John Dinkler, MD, MPH, Karol Watson, MD, PhD

Published in: Current Treatment Options in Cardiovascular Medicine | Issue 11/2014

Login to get access

Opinion statement

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States. Choosing the appropriate patients for whom to initiate statin therapy to reduce the risk of ASCVD is of paramount importance. The new AHA/ACC guidelines on the treatment of cholesterol emphasize a patient-centered approach that shifts away from arbitrary LDL-C goals and recommends targeting statin therapy in patient populations that show ASCVD risk-reduction benefit. In addition, the guidelines emphasize lifestyle modification and the importance of the clinician-patient relationship in discussing ASCVD risk and initiating statin therapy.
Literature
1.
go back to reference Go AS, Mozaffarian D, Roger VL, American Heart Association Statistics Committee and Stroke Statistics Subcommittee, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e6–245.PubMedCrossRef Go AS, Mozaffarian D, Roger VL, American Heart Association Statistics Committee and Stroke Statistics Subcommittee, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e6–245.PubMedCrossRef
2.••
go back to reference Mihaylova B, Emberson J, Blackwell L, Cholesterol Treatment Trialists’ (CTT) Collaborators, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012;380(9841):581–90. One of the key meta-analyses on which the new cholesterol guidelines are based. Mihaylova B, Emberson J, Blackwell L, Cholesterol Treatment Trialists’ (CTT) Collaborators, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012;380(9841):581–90. One of the key meta-analyses on which the new cholesterol guidelines are based.
3.••
go back to reference Taylor F, Huffman MD, Macedo AF, et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013;1(1):CD004816. doi:10.1002/14651858.CD14004816.pub14651855. One of the key meta-analyses on which the new cholesterol guidelines are based. Taylor F, Huffman MD, Macedo AF, et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013;1(1):CD004816. doi:10.​1002/​14651858.​CD14004816.​pub14651855. One of the key meta-analyses on which the new cholesterol guidelines are based.
4.••
go back to reference Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults [published online November 12, 2013]. Circulation. 2013. doi:10.1161/01.cir.0000437738.63853.7a. The new cholesterol guidelines in detail. Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults [published online November 12, 2013]. Circulation. 2013. doi:10.​1161/​01.​cir.​0000437738.​63853.​7a. The new cholesterol guidelines in detail.
5.
go back to reference Downs J, Claerfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. Results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;279:1615–22.PubMedCrossRef Downs J, Claerfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. Results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;279:1615–22.PubMedCrossRef
6.
go back to reference Ridker P, Danielson E, Fonseca F, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195–3207.PubMedCrossRef Ridker P, Danielson E, Fonseca F, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195–3207.PubMedCrossRef
7.
go back to reference Ridker P, Cook N. Statins: new American guidelines for preventions of cardiovascular disease. Lancet. 2013;382:1762–5.PubMedCrossRef Ridker P, Cook N. Statins: new American guidelines for preventions of cardiovascular disease. Lancet. 2013;382:1762–5.PubMedCrossRef
8.
go back to reference Cook N, Ridker P. Response to comment on the reports of over-estimation of ASCVD risk using the 2013 AHA/ACC risk equation. Circulation. 2014;129:268–9.PubMedCrossRef Cook N, Ridker P. Response to comment on the reports of over-estimation of ASCVD risk using the 2013 AHA/ACC risk equation. Circulation. 2014;129:268–9.PubMedCrossRef
9.
go back to reference Munter P, Colantonia LD, Cushman M, et al. Validation of the atherosclerotic cardiovascular disease Pooled Cohort risk equations. JAMA. 2014;311(14):1406–15.CrossRef Munter P, Colantonia LD, Cushman M, et al. Validation of the atherosclerotic cardiovascular disease Pooled Cohort risk equations. JAMA. 2014;311(14):1406–15.CrossRef
10.
go back to reference Grabowski DC, Lakdawalla DN, Goldman DP, et al. The large social value resulting from use of statins warrants steps to improve adherence and broaden treatment. Health Aff (Millwood). 2012;31(10):2276–85.CrossRef Grabowski DC, Lakdawalla DN, Goldman DP, et al. The large social value resulting from use of statins warrants steps to improve adherence and broaden treatment. Health Aff (Millwood). 2012;31(10):2276–85.CrossRef
11.
go back to reference Heart Protection Study Collaborative Group. Statin cost-effectiveness in the United States for people at different vascular risk levels. Circ Cardiovasc Qual Outcomes. 2009;2(2):65–72.CrossRef Heart Protection Study Collaborative Group. Statin cost-effectiveness in the United States for people at different vascular risk levels. Circ Cardiovasc Qual Outcomes. 2009;2(2):65–72.CrossRef
Metadata
Title
Practical Implementation of the 2013 AHA/ACC Blood Cholesterol Guidelines
Authors
John Dinkler, MD, MPH
Karol Watson, MD, PhD
Publication date
01-11-2014
Publisher
Springer US
Published in
Current Treatment Options in Cardiovascular Medicine / Issue 11/2014
Print ISSN: 1092-8464
Electronic ISSN: 1534-3189
DOI
https://doi.org/10.1007/s11936-014-0347-9

Other articles of this Issue 11/2014

Current Treatment Options in Cardiovascular Medicine 11/2014 Go to the issue

Pediatric Congenital Heart Disease (G Singh, Section Editor)

Current Approaches to the Management of Pediatric Overweight and Obesity

Pediatric Congenital Heart Disease (G Singh, Section Editor)

Impact of Childhood Obesity on Cardiac Structure and Function

Pediatric Congenital Heart Disease (G Singh, Section Editor)

Childhood Obesity, Arterial Stiffness, and Prevalence and Treatment of Hypertension