Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) guidelines for management of dyslipidemia and cardiovascular disease risk reduction: Putting evidence in context
| Autor: | Roger S. Blumenthal, Salim S. Virani, Paul A. Heidenreich, Lynne T. Braun, Sidney C. Smith, Kim K. Birtcher, Carl E. Orringer, Scott M. Grundy, Erin D. Michos, Neil J. Stone, Vijay Nambi, Mahmoud Al Rifai, Richard S. Schofield |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Consensus Time Factors Clinical Decision-Making Context (language use) Risk Assessment Lipid-lowering therapy Secondary Prevention Humans Medicine In patient Military Medicine Veterans Affairs Dyslipidemias business.industry Atherosclerotic cardiovascular disease Protective Factors United States Department of Defense medicine.disease United States Primary Prevention United States Department of Veterans Affairs Cholesterol Treatment Outcome Cardiovascular Diseases Heart Disease Risk Factors Emergency medicine Disease risk Statin therapy Drug Monitoring Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business Biomarkers Dyslipidemia |
| Zdroj: | Progress in Cardiovascular Diseases. 68:2-6 |
| ISSN: | 0033-0620 |
| DOI: | 10.1016/j.pcad.2021.08.001 |
| Popis: | Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality in the United States (U.S.) and incurs significant cost to the healthcare system. Management of cholesterol remains central for ASCVD prevention and has been the focus of multiple national guidelines. In this review, we compare the American Heart Association (AHA)/American College of Cardiology (ACC) and the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) Cholesterol guidelines. We review the evidence base that was used to generate recommendations focusing on 4 distinct themes: 1) the threshold of absolute 10-year ASCVD risk to start a clinician-patient discussion for the initiation of statin therapy in primary prevention patients; 2) the utility of coronary artery calcium score to guide clinician-patient risk discussion pertaining to the initiation of statin therapy for primary ASCVD prevention; 3) the use of moderate versus high-intensity statin therapy in patients with established ASCVD; and 4) the utility of ordering lipid panels after initiation or intensification of lipid lowering therapy to document efficacy and monitor adherence to lipid lowering therapy. We discuss why the VA/DoD and AHA/ACC may have reached different conclusions on these key issues. |
| Databáze: | OpenAIRE |
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