2013 ACC/AHA Guideline Recommends Fixed-Dose Strategies Instead of Targeted Goals to Lower Blood Cholesterol

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:64

Review

Smith, Sidney C., Jr.¹  Grundy, Scott M.^2,3 

[1] Univ N Carolina, Sch Med, Ctr Cardiovasc Sci & Med, Chapel Hill, NC 27599 USA

[2] Univ Texas Dallas, SW Med Ctr, Dallas, TX USA

[3] VA Med Ctr, Dallas, TX USA

关键词: atherosclerosis;    cardiovascular diseases;    cholesterol;    hydroxymethylglutaryl-CoA reductase inhibitors;    LDL;    lipoproteins;    risk assessment;    risk factors;   

DOI  :  10.1016/j.jacc.2014.06.1159

来源: Elsevier

【 摘 要 】

The American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines recently issued the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. This new guideline endorses a paradigm shift in strategies for reducing atherosclerotic cardiovascular disease (ASCVD) events by lowering blood cholesterol. Whereas previous guidelines focused on therapy to decrease low-density lipoprotein and non-high-density lipoprotein cholesterol to specific target levels, the new guideline instead proposes implementation of cholesterol-lowering treatment using evidenced-based intensity of statin therapy without such targets. The guideline also provides a new risk estimator for primary prevention decisions, including stroke outcomes and data on African Americans, which will significantly increase the number of patients recommended for outcome-related benefits of cholesterol-lowering therapy. The first section of this paper reviews the process by which the task force developed the new evidence-based guideline, the major findings and recommendations, and their implications. The second section primarily focuses on the question of how much low-density lipoprotein cholesterol should be lowered and on additional considerations in risk assessment. (C) 2014 by the American College of Cardiology Foundation.

【 授权许可】

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