The U.S. Department of Veterans Affairs and U.S. Department of Defense Guideline for the Management of Dyslipidemia: Is Moderate Risk Reduction Enough?
Authors: Alison L. Bailey, Charles L. Campbell
Journal: Annals of Internal Medicine (2020)

Editorials17 November 2020The U.S. Department of Veterans Affairs and U.S. Department of Defense Guideline for the Management of Dyslipidemia: Is Moderate Risk Reduction Enough?Alison L. Bailey, MD and Charles L. Campbell, MDAlison L. Bailey, MDCentennial Heart at Parkridge, Chattanooga, Tennessee (A.L.B.)Search for more papers by this author and Charles L. Campbell, MDPiedmont Heart Institute, Atlanta, Georgia (C.L.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-6125 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Cardiovascular disease (CVD) is the leading cause of death in the United States and is associated with considerable cardiovascular morbidity, disability, and cost. The economic burden in the United States was estimated to be more than $350 billion in 2015 and is projected to top $1 trillion by 2035 (1). It is well documented that a continuous association exists between low-density lipoprotein cholesterol (LDL-C) levels and atherosclerotic disease. Strategies aimed at reducing CVD events center largely around improving modifiable risk factors, assessing risk, and lowering LDL-C levels in patients at higher risk.In their Annals article, O'Malley and colleagues (2) ...References1. Virani SS, Alonso A, Benjamin EJ, et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2020 update: A report from the American Heart Association. Circulation. 2020;141:e139-e596. [PMID: 31992061] doi:10.1161/CIR.0000000000000757 CrossrefMedlineGoogle Scholar2. O'Malley PG, Arnold MJ, Kelley C, et al. Management of dyslipidemia for cardiovascular disease risk reduction: synopsis of the 2020 updated U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline. Ann Intern Med. 2020;173:822-9. doi:10.7326/M20-4648 LinkGoogle Scholar3. Reston JT, Buelt A, Donahue MP, et al. Interventions to improve statin tolerance and adherence in patients at risk for cardiovascular disease. A systematic review for the 2020 U.S. Department of Veterans Affairs and U.S. Department of Defense guidelines for management of dyslipidemia. Ann Intern Med. 2020;173:806-12. doi:10.7326/M20-4680 LinkGoogle Scholar4. Mach F, Baigent C, Catapano AL, et al; ESC Scientific Document Group. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41:111-188. [PMID: 31504418] doi:10.1093/eurheartj/ehz455 CrossrefMedlineGoogle Scholar5. Anderson TJ, Grégoire J, Pearson GJ, et al. 2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2016;32:1263-1282. [PMID: 27712954] doi:10.1016/j.cjca.2016.07.510 CrossrefMedlineGoogle Scholar6. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation. 2019;139:e1082-e1143. [PMID: 30586774] doi:10.1161/CIR.0000000000000625 CrossrefMedlineGoogle Scholar7. Mills EJ, O'Regan C, Eyawo O, et al. Intensive statin therapy compared with moderate dosing for prevention of cardiovascular events: a meta-analysis of >40 000 patients. Eur Heart J. 2011;32:1409-15. [PMID: 21385791] doi:10.1093/eurheartj/ehr035 CrossrefMedlineGoogle Scholar8. Collins R, Reith C, Emberson J, et al. Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet. 2016;388:2532-2561. [PMID: 27616593] doi:10.1016/S0140-6736(16)31357-5 CrossrefMedlineGoogle Scholar9. Budoff MJ, Young R, Burke G, et al. Ten-year association of coronary artery calcium with atherosclerotic cardiovascular disease (ASCVD) events: the Multi-Ethnic Study of Atherosclerosis (MESA). Eur Heart J. 2018;39:2401-2408. [PMID: 29688297] doi:10.1093/eurheartj/ehy217 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Centennial Heart at Parkridge, Chattanooga, Tennessee (A.L.B.)Piedmont Heart Institute, Atlanta, Georgia (C.L.C.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-6125.Corresponding Author: Alison L. Bailey, MD, Centennial Heart at Parkridge, Center for Heart, Lung and Vascular Health, 2333 McCallie Avenue, Chattanooga, TN 37404; e-mail, dr.alison.[email protected]com.Current Author Addresses: Dr. Bailey: Centennial Heart at Parkridge, Center for Heart, Lung and Vascular Health, 2333 McCallie Avenue, Chattanooga, TN 37404.Dr. Campbell: 191 Deep South Farm Road, Blairsville, GA 30512.This article was published at Annals.org on 22 September 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2020 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline Patrick G. O'Malley , Michael J. Arnold , Cathy Kelley , Lance Spacek , Andrew Buelt , Sundar Natarajan , Mark P. Donahue , Elena Vagichev , Jennifer Ballard-Hernandez , Amanda Logan , Lauren Thomas , Joan Ritter , Brian E. Neubauer , and John R. Downs Metrics 17 November 2020Volume 173, Issue 10Page: 846-847KeywordsCardiovascular diseasesCoronary artery calcificationDyslipidemiaHeartLow density lipoprotein cholesterolMortalityPopulation statisticsRadiation exposureStatinsTreatment guidelines ePublished: 22 September 2020 Issue Published: 17 November 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...