title: Increased statin eligibility based on ACC/AHA versus NCEP guidelines for high cholesterol management in Chile.
abstract: BACKGROUND
  In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) jointly released new guidelines for cardiovascular risk assessment and cholesterol management that substantially modified the previous recommendations proposed by the National Cholesterol Education Program (NCEP) in 2001. The relative impact of these new guidelines on potential statin use has not been estimated in Latin American populations.
  
  
  OBJECTIVE
  To estimate and compare eligibility for statin therapy based on ACC/AHA and NCEP guidelines in adult Chilean population.
  
  
  METHODS
  Using data from the last National Health Survey (2009-2010 NHS), we conducted a cross-sectional analysis in a ​representative sample of the Chilean adult population and calculated the proportion of individuals that would receive statins under each set of guidelines.
  
  
  RESULTS
  According to ACC/AHA guidelines, the population eligible for statin treatment increased from 21.7% (NCEP guidelines) to 33.2% (overall 53% increase). This effect was more pronounced among women (29.6% under ACC/AHA vs 15.6% under NCEP) and with those of advanced age (75% of the subjects >60 years of age compared with 46% under NCEP). The newly eligible group included more women and older subjects and individuals with lower LDL cholesterol levels.
  
  
  CONCLUSIONS
  Compared with NCEP recommendations, the new ACC/AHA guidelines significantly increased the number of Chilean adults eligible for statin therapy. Full implementation of the new recommendations may have important public health implications in Chile and other Latin American countries, as more women and older subjects without cardiovascular disease would qualify for statin treatment.
authors.affiliation: Centre for Molecular Nutrition and Chronic Diseases, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Echeverría
authors.affiliation: Centre for Molecular Nutrition and Chronic Diseases, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Catalina
authors.initials: C
authors.lastname: Dussaillant
authors.affiliation: Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Luis
authors.initials: L
authors.lastname: Villarroel
authors.affiliation: Centre for Molecular Nutrition and Chronic Diseases, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: arigotti@med.puc.cl.
authors.forename: Attilio
authors.initials: A
authors.lastname: Rigotti
mesh_terms: D000328:Adult; D000367:Age Factors; D000572:American Heart Association; D002309:Cardiology; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000378:metabolism; D002677:Chile; D002784:Cholesterol / Q000378:metabolism*; D005260:Female; D006306:Health Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D012306:Risk; D012737:Sex Factors; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol
keywords: Cardiovascular risk; Guidelines; LDL cholesterol; Statin therapy eligibility