title: Cardiac risk factors: new cholesterol and blood pressure management guidelines.
abstract: The 2013 American College of Cardiology/American Heart Association cholesterol guidelines depart from low-density lipoprotein (LDL) treatment targets and recommend treating four specific patient groups with statins. Statins are the only cholesterol-lowering drugs with randomized trial evidence of benefit for preventing atherosclerotic cardiovascular disease (ASCVD). The groups are patients with clinical ASCVD; patients ages 40 to 75 years with diabetes and LDL of 70 to 189 mg/dL but no clinical ASCVD; patients 21 years or older with LDL levels of 190 mg/dL or higher; and patients ages 40 to 75 years with LDL of 70 to 189 mg/dL without clinical ASCVD or diabetes but with 10-year ASCVD risk of 7.5% or higher. Ten-year ASCVD risk may be calculated using the Pooled Cohort Equations. The Eighth Joint National Committee (JNC 8) guidelines for blood pressure management recommend a blood pressure goal of less than 140/90 mm Hg for all adults except those 60 years or older. For the latter group, the JNC 8 recommends a systolic blood pressure goal of less than 150 mm Hg. In another notable change from prior guidelines, the JNC 8 recommends relaxing the systolic blood pressure goal for patients with diabetes and chronic kidney disease to less than 140 mm Hg from less than 130 mm Hg.
authors.affiliation: Memorial Hospital of Rhode Island, 111 Brewster St., Pawtucket, RI 02903, USA. david_anthony@brown.edu
authors.forename: David
authors.initials: D
authors.lastname: Anthony
authors.affiliation: Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, USA. Paul-George@Brown.edu
authors.forename: Paul
authors.initials: P
authors.lastname: George
authors.affiliation: Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903, USA. Charles_Eaton@Brown.edu
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000097:blood; D004032:Diet / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006973:Hypertension / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012307:Risk Factors; D014481:United States; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors