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Patient-Centered and Practical Application of New High Cholesterol Guidelines to Prevent Cardiovascular Disease

Victor M. Montori, MD, MSc1,2; Juan P. Brito, MD1,2; Henry H. Ting, MD, MBA3
[+] Author Affiliations
1Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
2Knowledge and Evaluation Research Unit, Division of Endocrinology, Mayo Clinic, Rochester, Minnesota
3Knowledge and Evaluation Research Unit, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
JAMA. 2014;311(5):465-466. doi:10.1001/jama.2014.110.
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Video.Online Aid to Assist Patient Decisions About Use of Statins

This video illustrates use of an online decision aid to help patients understand the benefits and harms of using statins to reduce their 10-year cardiovascular risk.

In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) published new guidelines for assessing cardiovascular disease (CVD) risk1 and for treatment of blood cholesterol to reduce CVD.2 These new guidelines replaced the Adult Treatment Panel III (ATP III) guidelines for the detection, evaluation, and treatment of high blood cholesterol3 that guided clinical practice for more than a decade. The new guidelines divert focus from lowering low-density lipoprotein (LDL) cholesterol levels to treating CVD risk and therefore are no longer pure cholesterol guidelines like the ATP III predecessor. The new guidelines also discourage the prescription of lipid-lowering medications, such as ezetimibe or niacin, that do not have proven effect on reducing CVD risk. These changes represent a major shift in preventive cardiology.

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