Current guidelines for cardiovascular disease (CVD) prevention use 2 different strategies. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines,1 with a few exceptions such as markedly elevated low-density-lipoprotein cholesterol (LDL-C) or diabetes mellitus, base their primary preventive treatment recommendations on calculated 10-year CVD risk. In contrast, blood pressure treatment recommendations are based on levels of systolic and diastolic blood pressure, with no explicit inclusion of estimated CVD risk.2 In 2016, the consequences for the US population of the benefit model for prevention, which includes both the predicted risk and the reduction in that risk expected with treatment, have been explicated.3 In this Viewpoint, we contrast the implications of benefit vs risk-based prevention strategies, demonstrate why the benefit model offers the optimal approach to CVD prevention, and explain how it needs to be extended to other risk factors.
Thanassoulis G, Pencina MJ, Sniderman AD. The Benefit Model for Prevention of Cardiovascular Disease: An Opportunity to Harmonize Guidelines . JAMA Cardiol. 2017;2(11):1175–1176. doi:10.1001/jamacardio.2017.2543
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