Application of New Guidelines for the Primary Prevention of Atherosclerotic Cardiovascular Disease in a Korean Population

American College of Cardiology/American Heart Association (ACC/AHA) Class I Guidelines for the Treatment of Cholesterol to Reduce Atherosclerotic Cardiovascular Risk: Implications for US Hispanics/Latinos Based on Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

“…To our knowledge, this is the first population‐based study of Hispanics/Latinos living in the United States that has provided prevalence estimates of statin eligibility under 2013 ACC/AHA cholesterol and 2004 NCEP/ATP III cholesterol treatment guidelines. The findings of this study are consistent with other studies showing increase in statin eligibility among whites, Europeans, and Koreans, Mexican majority Hispanics, and Chileans . The newer guidelines have expanded the indications for statin therapy by including ASCVD risk score and have shown almost doubling of the statin eligibility .…”

2013 ACC/AHA Cholesterol Guideline Versus 2004 NCEP ATP III Guideline in the Prediction of Coronary Artery Calcification Progression in a Korean Population

“…Last, ASCVD is one of the most important global causes of morbidity and mortality, and the most important and clinically treatable risk factor is LDL‐C 30. Therefore, given the favorable safety profile of statins and disastrous outcomes of CHD, the benefits of statin therapy clearly outweigh the risks of overtreatment in an era when CHD remains a world‐wide public health issue 29, 30, 31…”

“…Furthermore, a review of randomized statin trials demonstrated that statin therapy is associated with a slightly increased risk of transaminase elevations, but not of myalgias, creatine kinase elevations, rhabdomyolysis, or withdrawal of therapy compared with placebo. 29 Last, ASCVD is one of the most important global causes of morbidity and mortality, and the most important and clinically treatable risk factor is LDL-C. 30 Therefore, given the favorable safety profile of statins and disastrous outcomes of CHD, the benefits of statin therapy clearly outweigh the risks of overtreatment in an era when CHD remains a world-wide public health issue. [29][30][31] In addition, some studies reported that the ACC/AHA guidelines improved the alignment of statin eligibility.…”

“…29 Last, ASCVD is one of the most important global causes of morbidity and mortality, and the most important and clinically treatable risk factor is LDL-C. 30 Therefore, given the favorable safety profile of statins and disastrous outcomes of CHD, the benefits of statin therapy clearly outweigh the risks of overtreatment in an era when CHD remains a world-wide public health issue. [29][30][31] In addition, some studies reported that the ACC/AHA guidelines improved the alignment of statin eligibility. 5,32,33 Recently, Ko et al 27 reported that, in the Korean population, the ACC/AHA guidelines would substantially increase the number of adults who would potentially be eligible for statin therapy and would recommend statin therapy for more adults who would have higher ASCVD events.…”

Similarities and differences between European and United States guidelines for the management of dyslipidaemias

“…Indeed recently, based on a large study population of 8,742 subjects plus data obtained from the 2008-2010 Korea National Health and Nutrition Examination Survey of 16,892 adults, the Korean authors have concluded that adopting the new US guidelines would result in the treatment of almost all Korean men and women (≥ 60 years and ≥ 70 years of age, respectively) without evidence of ASCVD [50]. Therefore, overestimating the risk and treating many more subjects with statins than is necessary would have serious financial as well as health consequences.…”