Differences in primary cardiovascular disease prevention between the 2013 and 2016 cholesterol guidelines and impact of the 2017 hypertension guideline in the United States
| Autor: | Jiexiang Li, Robert A. Davis, Kevin Fiscella, Angelo Sinopoli, Daniel W. Jones, Brent M. Egan, Jonathan N. Tobin |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Advisory Committees 030204 cardiovascular system & hematology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Diabetes mellitus Internal Medicine Medicine Humans 030212 general & internal medicine Aged business.industry Cholesterol Atherosclerotic cardiovascular disease Number needed to harm Guideline Middle Aged medicine.disease United States Primary Prevention Cross-Sectional Studies Treatment Outcome chemistry Cardiovascular Diseases Concomitant Hypertension Practice Guidelines as Topic Number needed to treat Blood Pressure and Major Clinical Outcomes Female Cardiology and Cardiovascular Medicine business Dyslipidemia |
| Zdroj: | J Clin Hypertens (Greenwich) |
| ISSN: | 1751-7176 |
| Popis: | The US Preventive Services Task Force cholesterol guideline recommended statins for fewer adults than the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline by setting a higher 10-year atherosclerotic cardiovascular disease threshold (≥10.0% vs ≥7.5%) and requiring concomitant diabetes mellitus, hypertension, dyslipidemia, or cigarette smoking. The 2017 ACC/AHA hypertension guideline lowered the hypertension threshold, increasing 2016 guideline statin-eligible adults. Cross-sectional data on US adults aged 40 to 75 years enabled estimated numbers for the 2013 guideline and 2016 guideline with hypertension thresholds of ≥140/≥90 mm Hg and ≥130/80 mm Hg, respectively, on: (1) untreated, statin-eligible adults for primary atherosclerotic cardiovascular disease prevention (25.40, 14.72, 15.35 million); (2) atherosclerotic cardiovascular disease events prevented annually (124 000, 70 852, 73 199); (3) number needed to treat (21, 21, 21); and (4) number needed to harm (38, 143, 143) per 1000 patient-years for incident diabetes mellitus (42 800, 6700, 7100 cases per year). Despite the lower hypertension threshold, the 2013 cholesterol guideline qualifies approximately 10 million more adults for statins and prevents approximately 50 600 more primary atherosclerotic cardiovascular disease events but induces approximately 35 700 more diabetes mellitus cases annually than the 2016 guideline. |
| Databáze: | OpenAIRE |
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