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2013 American Cholesterol Treatment Guideline: What Was Done Well and What Could Be Done Better.
J Am Coll Cardiol. 2014 Mar 15;
Authors: Martin SS, Abd TT, Jones SR, Michos ED, Blumenthal RS, Blaha MJ
Abstract
Five years after convening the expert panel, the "2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults" was released. The American College of Cardiology and American Heart Association issued the guideline based on a systematic review of cholesterol treatment trials performed by the National Heart, Lung, and Blood Institute. This article critically appraises the guideline, and provides our view of "What Was Done Well" and "What Could Be Done Better." In particular, we propose that the guideline succeeds in prioritizing statin therapy, expanding focus to atherosclerotic cardiovascular disease including stroke, and in emphasizing absolute cardiovascular risk to determine statin eligibility. We contend that the guideline could be enhanced by refining the use of lipid goals rather than removing them, enhancing guidance on evaluation of cholesterol, and broadening the concept of age underpinning risk-based decision making to include vascular and physiologic age. We further suggest that the next guideline panel could comprehensively review current best evidence, build on existing guidelines, and cultivate broader national and international consensus. Overall, we aim to continue discussions about the important contributions and shortfalls of the guideline, and create momentum for effective implementation and timely updates.
PMID: 24681146 [PubMed - as supplied by publisher]