2016 US Preventive Services Task Force Statin Guidelines With Links To The References

 

This blog is simply my peripheral brain organized so that I can easily retrieve medical information that I want to be able to quickly access.

So that’s why I’ve included  the reference list from Reference (1). These footnotes basically include almost every important article relevant to cholesterol decision making in the past three years.

What follows are excerpts from Reference (1), Statin Use For Primary Prevention of Cardiovascular Disease in Adults United States Preventive Services Task Force Recommendation Statement 2016:

CONCLUSIONS AND RECOMMENDATIONS

The USPSTF recommends initiating use of low- to moderate-dose statins in adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of 10% or greater (B recommendation).

The USPSTF recommends that clinicians selectively offer low- to moderate-dose statins to adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors and a calculated 10-year CVD event risk of 7.5%to 10% (C recommendation).

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of initiating statin use in adults 76 years and older (I statement).

Identification of dyslipidemia and calculation of 10-year CVD
event risk requires universal lipids screening in adults aged40 to 75 years. See the “Clinical Considerations” section for more information on lipids screening and the assessment of cardiovascular risk.

Statins are a class of lipid-lowering medications that function
by inhibiting the enzyme 3-hydroxy-3-methyl-glutaryl coenzymeA reductase, which is involved in the rate-limiting step in the productionof cholesterol. Statins  reducelevels of total cholesterol and LDL-C and, to a lesser extent, triglycerides, and probably have antiinflammatory and plaque stabilization effects as well.6

The USPSTF found adequate evidence that the harms of low- to moderate-dose statin use in adults aged 40 to 75 years are small.

Risk Factors for CVD
For the purposes of this recommendation, dyslipidemia is defined as an LDL-C level greater than 130mg/dL or a high-density lipoprotein cholesterol (HDL-C) level less than40mg/dL (to convertHDL-C values to mmol/L, multiply by 0.0259). Most participants enrolled in trials of statin use for the prevention of CVD had an LDL-C level of 130 to 190 mg/dL or a diabetes diagnosis; hypertension and smoking were also common among trial participants.6  Persons with an LDL-C level greater than 190mg/dL were usually excluded from trial participation, as it was not considered appropriate to randomly assign them to placebo. Thus, these recommendations do not pertain to persons with very high cholesterol levels (ie,LDL-C>190mg/dL) or familialhypercholesterolemia, as they were excluded from most prevention trials.

fig1

 

Resources:

(1) Statin Use for the Primary Prevention of Cardiovascular Disease in Adults
US Preventive Services Task Force Recommendation Statement [PubMed Abstract] [Full Text HTML]. JAMA. 2016 Nov 15;316(19):1997-2007. doi: 10.1001/jama.2016.15450.*

(2) Statins for Primary Prevention: The Debate Is Intense, but the Data Are Weak. [PubMed Citation] [Full Text HTML]. JAMA. 2016 Nov 15;316(19):1979-1981. doi: 10.1001/jama.2016.15085.

(3) Interpretation and Use of Another Statin Guideline. [PubMed Abstract] [Full Text HTML]. JAMA. 2016 Nov 15;316(19):1977-1979. doi: 10.1001/jama.2016.15087.

*The following are the citations from Reference (1) above:

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