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The 2013 ACC/AHA Cholesterol Treatment Guidelines: Applicability to Patients with Diabetes

  • Macrovascular Complications in Diabetes (VR Aroda and A Getaneh, Section Editors)
  • Published:
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Abstract

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide and the management of blood cholesterol is a cornerstone of medical therapy for the primary and secondary prevention of cardiovascular disease. Patients with diabetes represent an important high-risk group in whom clinicians should advocate the use of statins and lifestyle modification for the reduction of ASCVD. The recent 2013 ACC/AHA guidelines on managing blood cholesterol provide an important framework for the effective implementation of this important risk reduction strategy. The guidelines identify four groups of individuals who have been shown to benefit from statin therapy and update the dosing and monitoring recommendations based on evidence from published, large-scale randomized controlled trials (RCTs) with clinical hard endpoints. Primary care physicians and specialists play key roles in identifying populations at elevated ASCVD risk and providing effective care for patients, especially those with diabetes. This article will summarize the 2013 ACC/AHA guidelines on managing blood cholesterol and provide a practical management overview in order to facilitate implementation of these guidelines for patients with diabetes.

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Abbreviations

ACC:

American College of Cardiology

ADA:

American Diabetes Association

AHA:

American Heart Association

ASCVD:

Atherosclerotic cardiovascular disease

CHD:

Coronary heart disease

DASH:

Dietary Approaches to Stop Hypertension

LDL-C:

Low-density lipoprotein-cholesterol

RCT:

Randomized controlled trial

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Mozaffarian D et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–322. Provides annual statistics and epidemiology on the burden of cardiovascular disease and risk factors in the United States.

    Article  PubMed  Google Scholar 

  2. Johansen ME, Green LA, Sen A, Kircher S, Richardson CR. Cardiovascular risk and statin use in the United States. Ann Fam Med. 2014;12:215–23.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Stone NJ et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013. doi:10.1016/j.jacc.2013.11.002. The ACC/AHA guideline based on randomized control trial data for the primary and secondary prevention atherosclerotic cardiovascular events.

    PubMed Central  Google Scholar 

  4. Libby P. Mechanisms of acute coronary syndromes and their implications for therapy. N Engl J Med. 2013;368:2004–13.

    Article  CAS  PubMed  Google Scholar 

  5. Eckel RH et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013. doi:10.1016/j.jacc.2013.11.003. Overview of the evidence for lifestyle interventions for improvement of cardiovacular health.

    Google Scholar 

  6. National Cholesterol Education Program, National Heart, Lung, and Blood Institute, N. I. of & Health. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106:3143–421.

    Google Scholar 

  7. Goff DC et al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2013. doi:10.1016/j.jacc.2013.11.005.

    PubMed  Google Scholar 

  8. D’Agostino RB et al. General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation. 2008;117:743–53.

    Article  PubMed  Google Scholar 

  9. Hayward RA, Krumholz HM. Three reasons to abandon low-density lipoprotein targets: an open letter to the Adult Treatment Panel IV of the National Institutes of Health. Circ Cardiovasc Qual Outcomes. 2012;5:2–5.

    Article  PubMed  Google Scholar 

  10. Emerging Risk Factors Collaboration et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med. 2011;364:829–41.

    Article  Google Scholar 

  11. Cholesterol Treatment Trialists’ (CTT) Collaborators et al. Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet (Lond, Engl). 2008;371:117–25.

    Article  Google Scholar 

  12. Stein EA et al. Effect of the proprotein convertase Subtilisin/Kexin 9 monoclonal antibody, AMG 145, in homozygous familial hypercholesterolemia. Circulation. 2013;128:2113–20.

    Article  CAS  PubMed  Google Scholar 

  13. Cannon CP et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015. doi:10.1056/NEJMoa1410489.

    Google Scholar 

  14. Stein EA et al. Effect of a monoclonal antibody to PCSK9, REGN727/SAR236553, to reduce low-density lipoprotein cholesterol in patients with heterozygous familial hypercholesterolaemia on stable statin dose with or without ezetimibe therapy: a phase 2 randomised controlled trial. Lancet. 2012;380:29–36.

    Article  CAS  PubMed  Google Scholar 

  15. Schwartz GG et al. Effect of alirocumab, a monoclonal antibody to PCSK9, on long-term cardiovascular outcomes following acute coronary syndromes: rationale and design of the ODYSSEY outcomes trial. Am Heart J. 2014;168:682–9.

    Article  CAS  PubMed  Google Scholar 

  16. Fox CS et al. Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: a scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care. 2015. doi:10.2337/dci15-0012. A consolidated guideline between the American Heart Association and American Diabetes Association on preventing cardiovascular disease in patient with type 2 diabetes mellitius.

    Google Scholar 

  17. Approaches D, Hypertension S. 8. Cardiovascular disease and risk management. Diabetes Care. 2015;38:S49–57.

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Boback Ziaeian, John Dinkler, Yuanlin Guo & Karol Watson

  2. Jonathan and Karin Fielding School of Public Health at UCLA, Los Angeles, CA, USA

    Boback Ziaeian & John Dinkler

  3. National Center for Cardiovascular Disease and Fu Wai Hospital, Beijing, China

    Yuanlin Guo

  4. UCLA Barbra Streisand Women’s Heart Health Program, Los Angeles, CA, USA

    Karol Watson

Authors
  1. Boback Ziaeian
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  2. John Dinkler
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  3. Yuanlin Guo
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  4. Karol Watson
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Corresponding author

Correspondence to Karol Watson.

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Conflict of Interest

Boback Ziaeian, John Dinkler, and Yuanlin Guo declare that they have no conflict of interest.

Karol Watson is consultant for Amgen, Astra Zeneca, and Merck & Co.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Macrovascular Complications in Diabetes

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Ziaeian, B., Dinkler, J., Guo, Y. et al. The 2013 ACC/AHA Cholesterol Treatment Guidelines: Applicability to Patients with Diabetes. Curr Diab Rep 16, 13 (2016). https://doi.org/10.1007/s11892-015-0703-5

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  • DOI: https://doi.org/10.1007/s11892-015-0703-5

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