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Low-density lipoprotein cholesterol goals: still not in patients' best interest
  1. Martin Mayer1,2
  1. 1Department of Physician Assistant Studies, East Carolina University, Greenville, North Carolina, USA
  2. 2Vidant Medical Center, Greenville, North Carolina, USA
  1. Correspondence to : Professor Martin Mayer,
    Department of Physician Assistant Studies, College of Allied Health Sciences, 4310N Health Sciences Building, Mail Stop 668, East Carolina University, Greenville, NC 27858-4353, USA; mayerm{at}ecu.edu

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In what became a highly-publicised move, the American Heart Association (AHA) and American College of Cardiology (ACC) effectively dropped low-density lipoprotein cholesterol (LDL-C) goals from their most recent guidelines pertaining to the matter. However, due to developments since the AHA and ACC released their current guidelines, some have called for a return to focusing on LDL-C goals. This article puts forth an overview of the salient issues at hand, important evidence-based considerations, and a conclusion that shifting focus away from LDL-C goals is clearly an evidence-based step in the right direction. Indeed, careful scrutiny of the current evidence base shows returning to LDL-C goals would be a mistake, and we should focus instead on overall cardiovascular risk, medications proven to reduce patient-relevant outcomes, and shared decision-making.

  • CARDIOLOGY
  • EPIDEMIOLOGY
  • INTERNAL MEDICINE
  • STATISTICS & RESEARCH METHODS
  • THERAPEUTICS

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Extract

In what became a highly-publicised move, the American Heart Association (AHA) and American College of Cardiology (ACC) effectively dropped low-density lipoprotein cholesterol (LDL-C) goals from their most recent guidelines pertaining to the matter. However, due to developments since the AHA and ACC released their current guidelines, some have called for a return to focusing on LDL-C goals. This article puts forth an overview of the salient issues at hand, important evidence-based considerations, and a conclusion that shifting focus away from LDL-C goals is clearly an evidence-based step in the right direction. Indeed, careful scrutiny of the current evidence base shows returning to LDL-C goals would be a mistake, and we should focus instead on overall cardiovascular risk, medications proven to reduce patient-relevant outcomes, and shared decision-making.

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