Skip Navigation
Menu
Editorials |16 January 2018

Comparison Shopping: Guidelines for Statins for Primary Prevention of Cardiovascular Disease

G.B. John Mancini, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
This article was published at Annals.org on 2 January 2018.
×
FULL TEXT
Developing clinical guidelines is complex. They must be well-focused for intended users and adhere to accepted standards (1, 2). Participants in their development must be selected to balance methodological and clinical expertise while mitigating conflicts of interest. Professional organizations worldwide have access to skilled experts and scientific evidence yet often arrive at different recommendations. These differences reflect the priorities, preferences, local needs, and practical realities of intended users. Thus, guidelines are well-reasoned, sociopolitical statements based on science. I have witnessed the care, professionalism, and passion required to generate a dyslipidemia guideline (3), but consensus can be elusive and, once achieved, difficult to shake. Herein lies the value of Mortensen and Nordestgaard's study (4).
Mortensen and Nordestgaard applied major recommendations from respected groups to 45 750 persons to determine statin eligibility for primary prevention of cardiovascular disease. They then assessed the actual versus modeled occurrence of atherosclerotic cardiovascular disease (ASCVD) over 10 years. Participants were enrolled in the Copenhagen General Population Study, were aged 40 to 75 years, and had no prior statin use or ASCVD. Reduction of ASCVD risk was calculated assuming a 25% relative risk reduction per 1-mmol/L (38.7-mg/dL) reduction in low-density lipoprotein cholesterol (LDL-C) level. The authors did analyses for 50% and 30% reductions of baseline LDL-C level. They also explored the potential effect of adding weaker recommendations warranting statin therapy as well as a narrower age range (40 to 65 years) to accommodate the age limits of the European Society...
FULL TEXT
PDF
Not Available
Citations
Citation

Mancini GJ. Comparison Shopping: Guidelines for Statins for Primary Prevention of Cardiovascular Disease. Ann Intern Med. [Epub ahead of print 2 January 2018]168:145–146. doi: 10.7326/M17-2917

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 2018;168(2):145-146.

DOI: 10.7326/M17-2917

Published at www.annals.org on 2 January 2018

©
2018 American College of Physicians
1 Citations

Related Articles
Comparison of Five Major Guidelines for Statin Use in Primary Prevention in a Contemporary General Population
Annals of Internal Medicine; 168 (2): 85-92
Annals for Educators - 16 January 2018
Annals of Internal Medicine; 168 (2): ED2
ACC/AHA guidelines determining statin eligibility better predicted CVD than ATP-III guidelines
Annals of Internal Medicine; 163 (10): JC11
The Cost-Effectiveness of Aspirin, Statins, or Both Drugs in the Primary Prevention of Heart Disease
Annals of Internal Medicine; 144 (5): I-29
View MoreView Less

Journal Club
ACC/AHA guidelines determining statin eligibility better predicted CVD than ATP-III guidelines
Annals of Internal Medicine; 163 (10): JC11
In primary prevention, the ACC/AHA risk-based approach predicted ASCVD better than trial-based or hybrid approaches
Annals of Internal Medicine; 164 (8): JC47
Review: In noncardiac surgery, amiodarone, β-blocker, or statin prophylaxis reduces postoperative AF
Annals of Internal Medicine; 169 (2): JC7
Evolocumab reduced CV events in patients with atherosclerotic CV disease taking high- or moderate-intensity statins
Annals of Internal Medicine; 167 (2): JC7
View MoreView Less

Related Point of Care
Peripheral Arterial Disease
Annals of Internal Medicine; 146 (5): ITC3-1
View MoreView Less

Related Topics
Cardiology
Coronary Risk Factors
Dyslipidemia
Prevention/Screening

Cardiology, Coronary Risk Factors, Dyslipidemia, Prevention/Screening.

PubMed Articles
Vitamin D Replacement Mitigates Menopause-Associated Dyslipidaemia and Atherogenic Indices in Ovariectomized Rats; A Biochemical Study.
Exp Clin Endocrinol Diabetes 2019.
Long-term neighborhood ethnic composition and weight-related outcomes among immigrants: The Multi-Ethnic Study of Atherosclerosis.
Health Place 2019;
View More

Results provided by: PubMed

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×