TY - JOUR
T1 - Refining Statin Prescribing in Lower-Risk Individuals
T2 - Informing Risk/Benefit Decisions
AU - Pender, Ashley
AU - Lloyd-Jones, Donald M.
AU - Stone, Neil J.
AU - Greenland, Philip
N1 - Publisher Copyright:
© 2016 American College of Cardiology Foundation
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2016/10/11
Y1 - 2016/10/11
N2 - Guidelines from the American College of Cardiology/American Heart Association, as well as those from the Veterans Affairs/Department of Defense and the Joint British Societies all recommended treating more people with statins than previous guidelines. In each guideline, the decision-making process began with an assessment of overall cardiovascular risk. Each group proposed updated treatment thresholds, and all of them lowered the threshold compared with earlier guidelines. Since release of these new guidelines in 2013 and 2014, additional evidence has emerged to suggest a rationale for extending statin consideration to an even larger proportion of asymptomatic adults—even those with a 10-year atherosclerotic cardiovascular disease risk below 7.5%. This review discusses new findings since 2013 and proposes strategies emanating from the current guidelines to help clinicians and patients make more informed decisions about long-term statin use, especially pertinent to lower-risk patients.
AB - Guidelines from the American College of Cardiology/American Heart Association, as well as those from the Veterans Affairs/Department of Defense and the Joint British Societies all recommended treating more people with statins than previous guidelines. In each guideline, the decision-making process began with an assessment of overall cardiovascular risk. Each group proposed updated treatment thresholds, and all of them lowered the threshold compared with earlier guidelines. Since release of these new guidelines in 2013 and 2014, additional evidence has emerged to suggest a rationale for extending statin consideration to an even larger proportion of asymptomatic adults—even those with a 10-year atherosclerotic cardiovascular disease risk below 7.5%. This review discusses new findings since 2013 and proposes strategies emanating from the current guidelines to help clinicians and patients make more informed decisions about long-term statin use, especially pertinent to lower-risk patients.
KW - atherosclerotic cardiovascular disease
KW - coronary artery calcium
KW - cost effectiveness
KW - primary prevention
UR - http://www.scopus.com/inward/record.url?scp=84994111916&partnerID=8YFLogxK
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U2 - 10.1016/j.jacc.2016.07.753
DO - 10.1016/j.jacc.2016.07.753
M3 - Review article
C2 - 27712783
AN - SCOPUS:84994111916
VL - 68
SP - 1690
EP - 1697
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 15
ER -