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Comment & Response
November 17, 2015

Predicted vs Observed Clinical Event Risk for Cardiovascular Disease

Author Affiliations
  • 1University of Louisville, Louisville, Kentucky
  • 2Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland
JAMA. 2015;314(19):2082. doi:10.1001/jama.2015.12916

To the Editor Overestimation of atherosclerotic cardiovascular disease (ASCVD) risk by the American College of Cardiology/American Heart Association (ACC/AHA) guidelines has been previously described.13 Dr Pursnani and colleagues4 reported that in a primary prevention cohort from the offspring and third-generation cohorts of the Framingham Heart Study, the 2013 ACC/AHA cholesterol treatment guidelines increased statin eligibility by 25% compared with previous national guidelines (2004 Updated Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [ATP III]). As with other cohorts, it appears that the majority of participants deemed to be newly statin eligible by the ACC/AHA guidelines gained this status because of a calculated ASCVD risk score greater than 7.5% over 10 years.5

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