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Hipertens Riesgo Vasc. 2015 Apr-Jun;32(2):83-91. doi: 10.1016/j.hipert.2014.09.002. Epub 2014 Nov 14.

[Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology Position Statement on Dyslipidemia Management. Differences Between the European and American Guidelines].

[Article in Spanish]

Author information

1
Comité Español Interdisciplinario de Prevención Cardiovascular, España; Sociedad Española de Medicina de Familia y Comunitaria, Madrid, España.
2
Sección de Riesgo Vascular y Rehabilitación Cardiaca, Sociedad Española de Cardiología, Madrid, España. Electronic address: egalve@vhebron.net.
3
Comité Español Interdisciplinario de Prevención Cardiovascular, España; Instituto de Salud Carlos III, Madrid, España.
4
Sección de Riesgo Vascular y Rehabilitación Cardiaca, Sociedad Española de Cardiología, Madrid, España.
5
Comité Español Interdisciplinario de Prevención Cardiovascular, España; Sociedad Española de Hipertensión-Liga Española de la Lucha Contra la Hipertensión Arterial, Madrid, España.
6
Comité Español Interdisciplinario de Prevención Cardiovascular, España; Sociedad Española de Medicina Interna, Madrid, España.
7
Comité Español Interdisciplinario de Prevención Cardiovascular, España; Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS), Madrid, España.
8
Sociedad Española de Medicina de Familia y Comunitaria, Madrid, España.
9
Comité Español Interdisciplinario de Prevención Cardiovascular, España; Sociedad Española de Diabetes, Madrid, España.
10
Sociedad Española de Arteriosclerosis, Madrid, España.
11
Comité Español Interdisciplinario de Prevención Cardiovascular, España; Sociedad Española de Arteriosclerosis, Madrid, España.
12
Sociedad Española de Cardiología, Madrid, España.

Abstract

The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention.

KEYWORDS:

Cardiovascular prevention; Clinical guidelines; Dislipemias; Dyslipidemia; Guías clínicas; Prevención cardiovascular

PMID:
26179969
DOI:
10.1016/j.hipert.2014.09.002
[Indexed for MEDLINE]

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