2013 ACC/AHA Cholesterol Guideline and Implications for Healthy People 2020 Cardiovascular Disease Prevention Goals

• Published in: Journal of the American Heart Association 2016-08, Vol.5 (8), p.n/a
• Main Authors: Egan, Brent M., Li, Jiexiang, White, Kellee, Fleming, Douglas O., Connell, Kenneth, Hernandez, German T., Jones, Daniel W., Ferdinand, Keith C., Sinopoli, Angelo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anticholesteremic Agents - therapeutic use; Atherosclerosis - prevention & control; cardiovascular disease; cholesterol; Cholesterol, LDL - drug effects; Cholesterol, LDL - metabolism; epidemiology; Female; Goals; guideline; Healthy People Programs; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia - prevention & control; Male; Middle Aged; Numbers Needed To Treat; Original Research; Practice Guidelines as Topic; Primary Prevention; Secondary Prevention; statin; Young Adult
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.116.003558

Background Healthy People 2020 aim to reduce fatal atherosclerotic cardiovascular disease (ASCVD) by 20%, which translates into 310 000 fewer events annually assuming proportional reduction in fatal and nonfatal ASCVD. We estimated preventable ASCVD events by implementing the American College of Cardiology/American Heart Association (ACC/AHA) 2013 Cholesterol Guideline in all statin‐eligible adults. Absolute risk reduction (ARR) and number needed‐to‐treat (NNT) were calculated. Methods and Results National Health and Nutrition Examination Survey data for 2007–2012 were analyzed for adults aged 21 to 79 years and extrapolated to the US population. Literature‐guided assumptions were used including (1) low‐density lipoprotein cholesterol falls 33% with moderate‐intensity statins and 51% with high‐intensity statins; (2) for each 39 mg/dL decline in low‐density lipoprotein cholesterol, 10‐year ASCVD10 risk would fall 21% when ASCVD10 risk was ≥20% and 33% when ASCVD10 risk was