Impact of Implementing the 2013 ACC/AHA Cholesterol Guidelines on Vascular Events in a Statewide Community‐Based Practice Registry |
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Authors: | Brent M. Egan MD Jiexiang Li PhD Douglas O. Fleming MPH Kellee White PhD Kenneth Connell MBBS PhD Robert A. Davis MS Angelo Sinopoli MD |
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Affiliation: | 1. Greenville Health System, Care Coordination Institute, University of South Carolina School of Medicine–Greenville, Greenville, SC;2. Department of Medicine, University of South Carolina School of Medicine–Greenville, Greenville, SC;3. Department of Mathematics, College of Charleston, Charleston, SC;4. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC;5. Faculty of Medical Sciences, The University of the West Indies Cave Hill Campus, St. Michael, Barbados |
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Abstract: | Electronic health record data were analyzed to estimate the number of statin‐eligible adults with the 2013 American College of Cardiology/American Heart Association cholesterol guidelines not taking statin therapy and the impact of recommended statin therapy on 10‐year atherosclerotic cardiovascular disease (ASCVD10) events. Adults aged 21 to 80 years in an outpatient network with ≥1 clinic visit(s) from January 2011 to June 2014 with data to calculate ASCVD10 were eligible. Moderate‐intensity statin therapy was assumed to lower low‐density lipoprotein cholesterol by 30% and high‐intensity therapy was assumed to reduce low‐density lipoprotein cholesterol by 50%. ASCVD events were assumed to decline 22% for each 39 mg/dL decline in low‐density lipoprotein cholesterol. Among 411,768 adults, 260,434 (63.2%) were not taking statins and 103,478 (39.7%) were eligible for a statin, including 79,069 (76.4%) patients with hypertension. Estimated ASCVD10 events were 18,781 without and 13,328 with statin therapy, a 29.0% relative and 5.3% absolute risk reduction with a number needed to treat of 19. The 2013 cholesterol guidelines are a relatively efficient approach to reducing ASCVD in untreated, statin‐eligible adults who often have concomitant hypertension. |
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