JCL roundtable. The 2018 AHA/ACC/Multisociety Cholesterol Guidelines: Process and product

Lynne T. Braun, Joseph J. Saseen, Carl E. Orringer, Neil J. Stone, John R. Guyton*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


In this NLA Roundtable four members of the writing committee join the Editor to discuss the process of developing the AHA/ACC/Multisociety Cholesterol Guidelines, which were unveiled in November 2018. They also provide personal insights on the finished product. Highlights include 1) the committee's decision to summarize 10 take-home messages providing rapid communication of key points, 2) emphasis on clinician -patient discussion, which may bring up issues specific to women or other population groups at risk, 3) personalizing risk with risk-enhancing factors such as LDL-C ≥ 160 mg/dl, metabolic syndrome, chronic kidney disease, pre-eclampsia, premature menopause, high risk ethnicity, inflammatory diseases, hypertriglyceridemia and in selected cases, Lp(a), hs-CRP and apoB; 4) using coronary artery calcium scoring when a risk decision is uncertain in intermediate risk patients 5) monitoring for goals of moderate or intensive LDL cholesterol reduction, 6) thresholds for adding nonstatin LDL-lowering therapy in those at very high risk or for heterozygous familial hypercholesterolemia and 7) cost value assessment for expensive treatment.

Original languageEnglish (US)
Pages (from-to)345-355
Number of pages11
JournalJournal of Clinical Lipidology
Issue number3
StatePublished - May 1 2019


  • Cholesterol guidelines
  • Coronary calcium scoring
  • Cost value assessment
  • Evidence-based medicine
  • Lipid clinical practice
  • Risk-enhancing factors

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine


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