title: 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.
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.
authors.forename: José María
authors.initials: JM
authors.lastname: Lobos Bejarano
authors.forename: Enrique
authors.initials: E
authors.lastname: Galve
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Royo-Bordonada
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alegría Ezquerra
authors.forename: Pedro
authors.initials: P
authors.lastname: Armario
authors.forename: Carlos
authors.initials: C
authors.lastname: Brotons Cuixart
authors.forename: Miguel
authors.initials: M
authors.lastname: Camafort Babkowski
authors.forename: Alberto
authors.initials: A
authors.lastname: Cordero Fort
authors.forename: Antonio
authors.initials: A
authors.lastname: Maiques Galán
authors.forename: Teresa
authors.initials: T
authors.lastname: Mantilla Morató
authors.forename: Antonio
authors.initials: A
authors.lastname: Pérez Pérez
authors.forename: Juan
authors.initials: J
authors.lastname: Pedro-Botet
authors.forename: Fernando
authors.initials: F
authors.lastname: Villar Álvarez
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González-Juanatey
mesh_terms: D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D011322:Primary Prevention / Q000592:standards; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D014481:United States
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors