Wiener klinische Wochenschrift

, Volume 126, Issue 5–6, pp 169–175 | Cite as

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

  • Gerald Klose
  • Frank Ulrich Beil
  • Hans Dieplinger
  • Arnold von Eckardstein
  • Bernhard Föger
  • Ioanna Gouni-Berthold
  • Franz Heigl
  • Wolfgang Koenig
  • Gert M. Kostner
  • Ulf Landmesser
  • Ulrich Laufs
  • Frank Leistikow
  • Winfried März
  • Georg Noll
  • Klaus G. Parhofer
  • Bernhard Paulweber
  • Walter F. Riesen
  • Jürgen R. Schaefer
  • Elisabeth Steinhagen-Thiessen
  • Armin Steinmetz
  • Hermann Toplak
  • Christoph Wanner
  • Eberhard Windler
perspective

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 

References

  1. 1.
    Reiner Z, Catapano AL, De Backer G, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32:1769–818.PubMedCrossRefGoogle Scholar
  2. 2.
    Perk J, De Backer G, Gohlke H, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2012;33:1635–701.PubMedCrossRefGoogle Scholar
  3. 3.
    Stone NJ, Robinson J, Lichtenstein AH, 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. Circulation. 2013 Nov 12th (Epub ahead of print).Google Scholar
  4. 4.
    National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). 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
  5. 5.
    Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110:227–39.PubMedCrossRefGoogle Scholar
  6. 6.
    Pedersen TR, Faergeman O, Kastelein JJ, et al. High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial. JAMA. 2005;294:2437–45.PubMedCrossRefGoogle Scholar
  7. 7.
    Zyriax BC, Boeing H, Windler E. Nutrition is a powerful independent risk factor for coronary heart disease in women—The CORA study: a population-based case-control study. Eur J Clin Nutr. 2005;59:1201–7.PubMedCrossRefGoogle Scholar
  8. 8.
    März W, Scharnagl H, Winkler K, et al. Low-density lipoprotein triglycerides associated with low-grade systemic inflammation, adhesion molecules, and angiographic coronary artery disease: the Ludwigshafen Risk and Cardiovascular Health study. Circulation. 2004;110:3068–74.PubMedCrossRefGoogle Scholar
  9. 9.
    DeGorter MK, Tirona RG, Schwarz UI, et al. Clinical and pharmacogenetic predictors of circulating atorvastatin and rosuvastatin concentrations in routine clinical care. Circ Cardiovasc Genet. 2013;6:400–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Pedro-Botet J, Schaefer EJ, Bakker-Arkema RG, et al. Apolipoprotein E genotype affects plasma lipid response to atorvastatin in a gender specific manner. Atherosclerosis. 2001;158:183–93.PubMedCrossRefGoogle Scholar
  11. 11.
    Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383–9.Google Scholar
  12. 12.
    Tonelli M, Wanner C. Lipid management in chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2013 clinical practice guideline. Ann Intern Med. 2013 Dec 10th (Epub ahead of print).Google Scholar
  13. 13.
    Collins R, Armitage J, Parish S, Sleigh P, Peto R. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet. 2003;361:2005–16.PubMedCrossRefGoogle Scholar
  14. 14.
    Baigent C, Blackwell L, Emberson J, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670–81.PubMedCrossRefGoogle Scholar
  15. 15.
    The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators. Am J Epidemiol. 1989;129:687–702.Google Scholar
  16. 16.
    Fried LP, Borhani NO, Enright P, et al. The Cardiovascular Health Study: design and rationale. Ann Epidemiol. 1991;1:263–76.PubMedCrossRefGoogle Scholar
  17. 17.
    Friedman GD, Cutter GR, Donahue RP, et al. CARDIA: study design, recruitment, and some characteristics of the examined subjects. J Clin Epidemiol. 1988;41:1105–16.PubMedCrossRefGoogle Scholar
  18. 18.
    Anderson KM, Odell PM, Wilson PW, Kannel WB. Cardiovascular disease risk profiles. Am Heart J. 1991;121:293–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–47.PubMedCrossRefGoogle Scholar
  20. 20.
    D’Agostino RB Sr, Grundy S, Sullivan LM, Wilson P. Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA. 2001;286:180–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013;382:1762–5.PubMedCrossRefGoogle Scholar
  22. 22.
    Goff DC Jr, Lloyd-Jones DM, Bennett G, 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. Circulation. 2013 Nov 12th (Epub ahead of print).Google Scholar
  23. 23.
    Ference BA, Yoo W, Alesh I, et al. Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: a Mendelian randomization analysis. J Am Coll Cardiol. 2012;60:2631–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Wilkins JT, Ning H, Berry J, Zhao L, Dyer AR, Lloyd-Jones DM. Lifetime risk and years lived free of total cardiovascular disease. JAMA. 2012;308:1795–801.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Berry JD, Dyer A, Cai X, et al. Lifetime risks of cardiovascular disease. N Engl J Med. 2012;366:321–9.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Gerald Klose
    • 1
  • Frank Ulrich Beil
    • 2
  • Hans Dieplinger
    • 3
  • Arnold von Eckardstein
    • 4
  • Bernhard Föger
    • 5
  • Ioanna Gouni-Berthold
    • 6
  • Franz Heigl
    • 7
  • Wolfgang Koenig
    • 8
  • Gert M. Kostner
    • 9
  • Ulf Landmesser
    • 10
  • Ulrich Laufs
    • 11
  • Frank Leistikow
    • 12
  • Winfried März
    • 13
    • 14
    • 15
  • Georg Noll
    • 10
  • Klaus G. Parhofer
    • 16
  • Bernhard Paulweber
    • 17
  • Walter F. Riesen
    • 18
  • Jürgen R. Schaefer
    • 19
  • Elisabeth Steinhagen-Thiessen
    • 20
    • 21
  • Armin Steinmetz
    • 22
  • Hermann Toplak
    • 23
  • Christoph Wanner
    • 24
  • Eberhard Windler
    • 25
  1. 1.Practice for Internal Medicine, Gastroenterology, Cardiology and Preventive MedicineBremenGermany
  2. 2.Outpatient Clinic for Endocrinology and MetabolismUniversity Clinic Hamburg-EppendorfHamburgGermany
  3. 3.Section of Genetic Epidemiology, Department for Medical Genetics and Molecular and Clinical PharmacologyMedical UniversityInnsbruckAustria
  4. 4.Institute for Clinical ChemistryUniversity HospitalZurichSwitzerland
  5. 5.Department of Internal MedicineRegional Hospital BregenzBregenzAustria
  6. 6.Center for Endocrinology, Diabetes and Preventive MedicineUniversity of CologneCologneGermany
  7. 7.Medical Health Care Center Kempten-AllgäuKemptenGermany
  8. 8.Department of Internal Medicine II – CardiologyUniversity of Ulm Medical CenterUlmGermany
  9. 9.Institute for Molecular Biology und Biochemistry, Center for Molecular MedicineMedical UniversityGrazAustria
  10. 10.Cardiology ClinicUniversity HospitalZurichSwitzerland
  11. 11.Clinic for Internal Medicine III (Cardiology, Angiology and Medical Intensive Care)University Clinic of SaarlandHomburgGermany
  12. 12.Kidney Center MannheimMannheimGermany
  13. 13.Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, and Rheumatology)Medical Faculty Mannheim of the University of HeidelbergMannheimGermany
  14. 14.Clinical Institute for Medical and Chemical Laboratory DiagnosticsMedical University of GrazGrazAustria
  15. 15.Synlab AcademySynlab Services GmbHMannheimGermany
  16. 16.Medical Clinic II, Campus GroßhadernClinic of the Ludwig Maximilian-UniversityMunichGermany
  17. 17.University Clinic for Internal Medicine ILKH Salzburg – University Clinic of the Paracelsus Medical Private UniversitySalzburgAustria
  18. 18.UFL Private University in Principality of LiechtensteinTriesenLiechtenstein
  19. 19.Dr. Pohl Endowed Professorship for Preventive Cardiology, Clinic for Internal Medicine – CardiologyUniversity Clinic Gießen and MarburgMarburgGermany
  20. 20.Charité Medical UniversityBerlinGermany
  21. 21.Evangelical Geriatrics CenterBerlinGermany
  22. 22.Department of Internal Medicine, Sankt Nikolaus Stiftshospital GmbHTeaching Hospital of the University of BonnAndernachGermany
  23. 23.Department of Internal MedicineMedical UniversityGrazAustria
  24. 24.Medical Clinic and Policlinic IUniversity ClinicWürzburgGermany
  25. 25.Preventive Medicine, Clinic und Policlinic for General and Invasive Cardiology, University Heart CenterUniversity Clinic Hamburg-EppendorfHamburgGermany

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