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Comment & Response
September 12, 2017

Guideline Recommendations for Statin Therapy

Author Affiliations
  • 1Kaiser Permanente Washington Health Research Institute, Seattle, Washington
  • 2University of Iowa, Iowa City
  • 3Stanford University, Stanford, California
JAMA. 2017;318(10):963-964. doi:10.1001/jama.2017.11375

To the Editor Dr Pagidipati and colleagues1 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.2 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.2

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