title: Impact of Implementing the 2013 ACC/AHA Cholesterol Guidelines on Vascular Events in a Statewide Community-Based Practice Registry.
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.
authors.affiliation: Greenville Health System, Care Coordination Institute, University of South Carolina School of Medicine-Greenville, Greenville, SC.|Department of Medicine, University of South Carolina School of Medicine-Greenville, Greenville, SC.
authors.forename: Brent M
authors.initials: BM
authors.lastname: Egan
authors.affiliation: Department of Mathematics, College of Charleston, Charleston, SC.
authors.forename: Jiexiang
authors.initials: J
authors.lastname: Li
authors.affiliation: Greenville Health System, Care Coordination Institute, University of South Carolina School of Medicine-Greenville, Greenville, SC.
authors.forename: Douglas O
authors.initials: DO
authors.lastname: Fleming
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.
authors.forename: Kellee
authors.initials: K
authors.lastname: White
authors.affiliation: Faculty of Medical Sciences, The University of the West Indies Cave Hill Campus, St. Michael, Barbados.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Connell
authors.affiliation: Greenville Health System, Care Coordination Institute, University of South Carolina School of Medicine-Greenville, Greenville, SC.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Davis
authors.affiliation: Greenville Health System, Care Coordination Institute, University of South Carolina School of Medicine-Greenville, Greenville, SC.|Department of Medicine, University of South Carolina School of Medicine-Greenville, Greenville, SC.
authors.forename: Angelo
authors.initials: A
authors.lastname: Sinopoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000378:metabolism; D002784:Cholesterol / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D057286:Electronic Health Records; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications* / Q000378:metabolism; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol