perspective

Wiener klinische Wochenschrift

, Volume 126, Issue 5, pp 169-175

New AHA and ACC guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk

  • Gerald KloseAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive Medicine
  • , Frank Ulrich BeilAffiliated withOutpatient Clinic for Endocrinology and Metabolism, University Clinic Hamburg-Eppendorf
  • , Hans DieplingerAffiliated withSection of Genetic Epidemiology, Department for Medical Genetics and Molecular and Clinical Pharmacology, Medical University
  • , Arnold von EckardsteinAffiliated withInstitute for Clinical Chemistry, University Hospital
  • , Bernhard FögerAffiliated withDepartment of Internal Medicine, Regional Hospital Bregenz
  • , Ioanna Gouni-BertholdAffiliated withCenter for Endocrinology, Diabetes and Preventive Medicine, University of Cologne
  • , Franz HeiglAffiliated withMedical Health Care Center Kempten-Allgäu
  • , Wolfgang KoenigAffiliated withDepartment of Internal Medicine II – Cardiology, University of Ulm Medical Center
  • , Gert M. KostnerAffiliated withInstitute for Molecular Biology und Biochemistry, Center for Molecular Medicine, Medical University
    • , Ulf LandmesserAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineCardiology Clinic, University Hospital
    • , Ulrich LaufsAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineClinic for Internal Medicine III (Cardiology, Angiology and Medical Intensive Care), University Clinic of Saarland
    • , Frank LeistikowAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineKidney Center Mannheim
    • , Winfried MärzAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineMedical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, and Rheumatology), Medical Faculty Mannheim of the University of HeidelbergClinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of GrazSynlab Academy, Synlab Services GmbH Email author 
    • , Georg NollAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineCardiology Clinic, University Hospital
    • , Klaus G. ParhoferAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineMedical Clinic II, Campus Großhadern, Clinic of the Ludwig Maximilian-University
    • , Bernhard PaulweberAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineUniversity Clinic for Internal Medicine I, LKH Salzburg – University Clinic of the Paracelsus Medical Private University
    • , Walter F. RiesenAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineUFL Private University in Principality of Liechtenstein
    • , Jürgen R. SchaeferAffiliated withPractice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineDr. Pohl Endowed Professorship for Preventive Cardiology, Clinic for Internal Medicine – Cardiology, University Clinic Gießen and Marburg
    • , Elisabeth Steinhagen-ThiessenAffiliated withOutpatient Clinic for Endocrinology and Metabolism, University Clinic Hamburg-EppendorfCharité Medical UniversityEvangelical Geriatrics Center
    • , Armin SteinmetzAffiliated withOutpatient Clinic for Endocrinology and Metabolism, University Clinic Hamburg-EppendorfDepartment of Internal Medicine, Sankt Nikolaus Stiftshospital GmbH, Teaching Hospital of the University of Bonn
    • , Hermann ToplakAffiliated withOutpatient Clinic for Endocrinology and Metabolism, University Clinic Hamburg-EppendorfDepartment of Internal Medicine, Medical University
    • , Christoph WannerAffiliated withOutpatient Clinic for Endocrinology and Metabolism, University Clinic Hamburg-EppendorfMedical Clinic and Policlinic I, University Clinic
    • , Eberhard WindlerAffiliated withOutpatient Clinic for Endocrinology and Metabolism, University Clinic Hamburg-EppendorfPreventive Medicine, Clinic und Policlinic for General and Invasive Cardiology, University Heart Center, University Clinic Hamburg-Eppendorf

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Summary

After the publication of the new guidelines of the European Society of Cardiology and the European Atherosclerosis Society for the prevention and treatment of dyslipidemias (Eur Heart J 32:1769–1818, 2011; Eur Heart J 33:1635–1701, 2012), a group of authors has recently published on behalf of the American Heart Association and the American College of Cardiology guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk (Circulation 2013). These new guidelines are supposed to replace the until now widely accepted, at least in the USA, recommendations of the National Cholesterol Education Program Adult Treatment Panel III from the years 2002 (Circulation 106:3143–3421, 2002) and 2004 (Circulation 110:227–39, 2004). Furthermore, they claim to be based mainly on hard evidence derived from the interpretation of results of prospective randomized controlled trials. This Joint Position Statement of the Society for the Prevention of Cardiovascular Diseases e. V. (D.A.CH), the Austrian Atherosclerosis Society and the Working Group on Lipids and Atherosclerosis (AGLA) of the Swiss Society of Cardiology concludes that the use of individualized prevention strategies based on specific indications and LDL cholesterol target concentrations, a strategy whose worth has been widely proven and accepted for more than a decade in Europe, should not be given up.

Keywords

Cholesterol LDL cholesterol Cardiovascular disease Atherosclerosis Guidelines Statins

Neue AHA und ACC-Leitlinie zur Risikoreduktion von Herz-Kreislauf-Erkrankungen durch Cholesterinsenkung (Gemeinsame Stellungnahme der D.A.CH-Gesellschaft Prävention von Herz-Kreislauf-Erkrankungen e.V., der Österreichischen Atherosklerose Gesellschaft und der Arbeitsgruppe Lipide und Atherosklerose (AGLA) der Schweizer Gesellschaft für Kardiologie)

Zusammenfassung

Nach der Publikation der Leitlinien der European Society of Cardiology (ESC) und der European Atherosclerosis Society (EAS) für die Prävention und Behandlung von Fettstoffwechselstörungen (Eur Heart J 32:1769-1818, 2011; Eur Heart J 33:1635-1701, 2012), hat kürzlich eine Autorengruppe im Namen der American Heart Association (AHA) und des American College of Cardiology (ACC) Leitlinien zur Absenkung des Risikos für Herz-Kreislauferkrankungen durch Cholesterinsenkung veröffentlicht (Circulation 2013). Diese neuen Leitlinien wollen, die bislang verbreitet, zumindest jedoch in den USA, akzeptierten Empfehlungen des NCEP/ATP (National Cholesterol Education Program Adult Treatment Panel) III aus den Jahren 2002 (Circulation 106:3121-3421, 2002) und 2004 (Circulation 110:227-39, 2004) abzulösen. Darüber hinaus beanspruchen sie, in erster Linie auf rigoroser Evidenz, hergeleitet aus der Interpretation von Ergebnissen prospektiver, randomisierter und kontrollierter Studien, zu beruhen.

Schlüsselwörter

Cholesterin LDL-cholesterin Kardiovaskuläre Erkrankungen Atherosklerose Statine