Author + information
- Received May 20, 2016
- Revision received June 30, 2016
- Accepted July 5, 2016
- Published online October 11, 2016.
- S0735109716348987-8590ba2da65c047dc248c09e3c7b0861Ashley Pender, MDa,
- S0735109716348987-9b9bcb2d09f399ff5f94b1c71883a1f3Donald M. Lloyd-Jones, MD, ScMa,b,c,
- S0735109716348987-0df4a63a52c97b535d326685ee6d8664Neil J. Stone, MDa,b and
- S0735109716348987-be026cf29df835995c6134560d7995e9Philip Greenland, MDa,b,c,∗ ()
- aDepartment of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- bDivision of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- cDepartment of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- ↵∗Reprint requests and correspondence:
Dr. Philip Greenland, Department of Preventive Medicine, Northwestern University, 680 North Lake Shore Drive, 14th Floor, Suite 600, Chicago, Illinois 60611.
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.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 20, 2016.
- Revision received June 30, 2016.
- Accepted July 5, 2016.
- American College of Cardiology Foundation
- Many Events Occur in “Low-Risk” People
- Accuracy of Risk Assessment Tools
- New Evidence on the Role of Additional Markers of Risk in Lower- and Intermediate-Risk Patients
- New Evidence on Cost Effectiveness of Statins
- New Evidence on Effectiveness of Statins on the Basis of Risk Alone
- Net Benefit as a Treatment Consideration
- New Evidence on the Frequency—and Likely Over-Reporting—of Statin Side Effects