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Elsevier España, Hipertensión y Riesgo Vascular, 2(32), p. 83-91

DOI: 10.1016/j.hipert.2014.09.002

Elsevier España, Medicina de Familia - SEMERGEN, 3(41), p. 149-157

DOI: 10.1016/j.semerg.2014.05.020

Elsevier, Clínica e Investigación en Arteriosclerosis, 1(27), p. 36-44

DOI: 10.1016/j.arteri.2014.09.001

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Posicionamiento del Comité Español Interdisciplinario de Prevención Cardiovascular y la Sociedad Española de Cardiología en el tratamiento de las dislipemias. Divergencia entre las guías europea y estadounidense

Journal article published in 2014 by Comité Español Interdisciplinario para la Prevención Cardiovascular (CEIPC), José María Lobos Bejarano, José María Lobos Bejarano, Enrique Galve, Miguel Angel Royo-Bordonada ORCID, Eduardo Alegría Ezquerra, Eduardo Alegría Ezquerra, Pedro Armario García, Carlos Brotons Cuixart, Miguel Camafort Babkowski ORCID, Miguel Camafort Babkowski, Alberto Cordero Fort, Alberto Cordero Fort, Antonio Maiques Galán, Antonio Maiques Galán and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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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. © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN).