Guideline Recommendations for Statin Therapy


To the Editor Dr Pagidipati and colleagues compared the US Preventive Services Task Force (USPSTF) recommendations and American College of Cardiology/American Heart Association (ACC/AHA) guidelines on primary prevention of cardiovascular disease (CVD) with statins. We agree that understanding the population effect of these guidelines is important. We wish to emphasize that the USPSTF issued 2 recommendations. The B recommendation applies to persons with a calculated 10-year CVD event risk of 10% or greater; the C recommendation applies to individuals with a calculated 10-year CVD event risk of 7.5% to 10%. The task force recommended low-dose to moderate-dose statins when patients meet all of the following criteria: (1) aged 40 to 75 years; (2) 1 or more CVD risk factors (ie, dyslipidemia, diabetes, hypertension, or smoking); and (3) a calculated 10-year CVD event risk of 10% or greater. Clinicians may choose to offer low- to moderate-dose statins to certain adults without a history of CVD when they meet all of the following criteria: (1) aged 40 to 75 years; (2) 1 or more CVD risk factors; and (3) a calculated 10-year CVD event risk of 7.5% to 10%. The differences between the USPSTF recommendations and the ACC/AHA guidelines are outlined in the recommendation statement.