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Choosing Between Guidelines: Statins for Primary CVD Prevention


Clinical guidelines on the initiation of statin therapy to prevent atherosclerotic cardiovascular disease (ASCVD) are published by several professional societies. A recent review1 compared 2 prominent sets of recommendations,2,3 applying guidance from each to a nationally representative US population. They found that approximately 15% (~16.0 million) fewer adults would be eligible for statin therapy for primary prevention under 2022 recommendations from the United States Preventive Services Task Force2 compared to the 2018 recommendatios from the American Heart Association/American College of Cardiology/ Multisociety consortium.3 Following is a Patient Care® Guideline Topline summary of what the authors found.

THE POPULATION: Ambulatory, non-pregnant US adults aged 40–75 years with LDL-C <190 mg/dL and no prevalent ASCVD from the National Health and Nutrition Examination Survey 2017–2020 (N=1799)

1. Gupta K, Kakar TS, Jain V, et al. Comparing eligibility for statin therapy for primary prevention under 2022 USPSTF recommendations and the 2018 AHA/ACC/ multi-society guideline recommendations: From National Health and Nutrition Examination Survey. Prog Cardiovasc Dis. 2022;75:78-82. doi:10.1016/j.pcad.2022.08.007

2. USPSTF. Statin use for the primary prevention of cardiovascular disease in adults: Preventive medication: United States Preventive Services Taskforce. February 22, 2022. Updated August 23, 2022. Accessed July 5, 2023. https://www.uspreventiveservicestaskforce.org/uspstf/
recommendation /statin-use-in-adults-preventive-medication

3. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA /ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1082-e143 doi:10.1161/CIR.0000000000000625

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