Statins & The New 2013 ACC/AHA Guidelines
In 2013, the American Heart Association (AHA) and the American College of Cardiology (ACC) released new guidelines for the treatment of dyslipidemia and prevention of atherosclerotic cardiovascular disease (ASCVD). The new guidelines deviate from the previous guidelines in that statin doses are NOT titrated to achieve a particular LDL target, but rather on a target percentage reduction in LDL.
Statin therapy is divided up into low, medium, and high intensities based on risk. A risk calculator provided by the AHA/ACC is available here, helping you determine the appropriate statin intensity based on various risk factors. The majority of patients receiving a statin for cholesterol lowering and prevention of ASCVD will likely fall into the medium risk category. See the criteria below for further details.
The web-based tool below can help you compare statins and determine which statin and selected statin strength can help achieve the percentage of LDL reduction based on risk stratification.
|Target Populations for Statin Intensities1|
|High (avg LDL reduction of > 50%)||Med (avg LDL reduction of 30-50%)||Low (avg LDL reduction of < 30%)|
|Secondary prevention in adults ≤75 years of age.||Primary prevention in diabetes patients 40-75 years of age with LDL and an estimated ASCVD risk of ≥ 7.5%||For patients who cannot tolerate high- or moderate-dose statin therapy.|
|Primary prevention in adults with LDL ≥ 190 mg/dL.||Secondary prevention in adults >75 years of age.|
|Primary prevention in adults 40-75 years of age with LDL and an estimated ASCVD risk of ≥ 7.5%.||Patients intolerant of high dose statins.|
|Primary prevention in diabetes patients 40-75 years of age with LDL and an estimated ASCVD risk of ≥ 7.5%.||Primary prevention in diabetes patients 40-75 years of age with LDL and an estimated ASCVD risk of < 7.5%.|
LDL Reduction %
1. PL Detail-Document, 2013 ACC/AHA Cholesterol Guidelines. Pharmacist’s Letter/Prescriber’s Letter. January 2014.
Disclaimer: The following information is for reference only and should not serve as a replacement for sound clinical judgement.