In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) published new guidelines for assessing cardiovascular disease (CVD) risk1 and for treatment of blood cholesterol to reduce CVD.2 These new guidelines replaced the Adult Treatment Panel III (ATP III) guidelines for the detection, evaluation, and treatment of high blood cholesterol3 that guided clinical practice for more than a decade. The new guidelines divert focus from lowering low-density lipoprotein (LDL) cholesterol levels to treating CVD risk and therefore are no longer pure cholesterol guidelines like the ATP III predecessor. The new guidelines also discourage the prescription of lipid-lowering medications, such as ezetimibe or niacin, that do not have proven effect on reducing CVD risk. These changes represent a major shift in preventive cardiology.
Victor M. Montori, Juan P. Brito, Henry H. Ting. Patient-Centered and Practical Application of New High Cholesterol Guidelines to Prevent Cardiovascular Disease. JAMA. 2014;311(5):465–466. doi:10.1001/jama.2014.110