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Use of controversial ACC/AHA guidelines for statin therapy is supported by US studies

BMJ 2015; 351 doi: (Published 20 July 2015) Cite this as: BMJ 2015;351:h3902
  1. Michael McCarthy
  1. 1Seattle

Controversial guidelines for lipid lowering statin therapy issued by the American College of Cardiology (ACC) and the American Heart Association (AHA) in 2013 do a better job of identifying people at risk of cardiovascular disease than the older guidelines, and they are cost effective even though they greatly increase the number of adults on these drugs, two studies have shown. The studies appeared in the 14 July issue of JAMA.1 2

When they were issued in 2013 the ACC/AHA guidelines3 challenged the established practice based on the 2004 National Cholesterol Education Program’s Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III; ATP III) guidelines.4 The ATP III guidelines placed a heavy emphasis on specific low density lipoprotein (LDL) cholesterol levels in deciding which patients should start statin therapy.

The ACC/AHA guidelines, by contrast, recommended basing the decision on a scoring system that included such factors as age, gender, blood pressure, …

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