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The 2013 American College of Cardiology/American Heart Association cholesterol treatment guideline recommends new equations (the Pooled Cohort risk equations) to estimate patients’ atherosclerotic cardiovascular disease (ASCVD) risk and to guide initiation of statin therapy. To provide external validation of the prediction models, Muntner and colleagues assessed the calibration and discrimination of the equations in a contemporary, population-based cohort (n = 18 498). The authors report the Pooled Cohort risk equations were well calibrated and demonstrated moderate to good discrimination in the population of individuals for which they were designed to be used. In an Editorial, Krumholz discusses implications of recently updated cholesterol and blood pressure treatment guidelines for patients and physicians.
Editorial and Related Articles 1 and 2
Kavousi and colleagues compared implications of applying 3 cardiovascular disease (CVD) prevention guidelines—the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline, the Adult Treatment Panel III guideline, and the European Society of Cardiology guideline—to 4584 Dutch participants in a prospective cohort study. Among the authors’ findings was that the proportion of individuals eligible for statin therapy differed substantially among the guidelines and that all 3 guideline-specific risk prediction models overestimated 10-year CVD risk.
Continuing Medical Education
In an analysis of data from the 2005-2010 National Health and Nutrition Examination Surveys (n = 16 372 individuals), Navar-Boggan and colleagues estimated the proportion of adults potentially affected by recommended changes in high blood pressure management specified in the 2014 guideline from the panel appointed to the Eighth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 8). The authors estimate that compared with the JNC 7 guideline, the JNC 8 guideline would result in fewer US adults recommended for hypertension treatment and an increased proportion of adults considered to have achieved blood pressure goals.
Author Video Interview
In a meta-analysis of data from 11 clinical trials, Lee and colleagues assessed survival among 1605 patients with advanced non–small-cell lung cancer harboring wild-type epidermal growth factor receptor (EGFR), who were randomly assigned to receive first-generation EGFR tyrosine kinase inhibitors or conventional chemotherapy. The authors report that compared with EGFR tyrosine kinase inhibitors, conventional chemotherapy was associated with improved progression-free survival but not overall survival.
Zinc ion blocks the cellular receptor for rhinoviruses in the nasal passages. In this JAMA Clinical Evidence Synopsis, Das and Singh summarize results of a Cochrane Collaboration review of 16 randomized trials (14 therapeutic; 2 prophylactic; 1781 participants) that compared oral zinc with placebo for reducing the duration, severity, and incidence of the common cold. Among the review findings was that when initiated within 24 hours of symptom onset, oral zinc was associated with a shorter duration of cold symptoms but did not differ from placebo in reducing symptom severity. Used prophylactically (mean duration, 6 months), oral zinc reduced cold incidence among children.
A recent article in JAMA Internal Medicine reported 2005-2011 trends in invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in the United States. In this From The JAMA Network article, Malani discusses the changing epidemiology of invasive MRSA infections and implications for future preventive efforts.
Highlights. JAMA. 2014;311(14):1373–1375. doi:10.1001/jama.2013.279430
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