ACC: Lifestyle, Statins Should be First for Cholesterol Lowering

Contact: Nicole Napoli,, 202-375-6523

WASHINGTON (Aug 10, 2015) -

American College of Cardiology President Kim Allan Williams Sr., M.D., FACC, made the following statement regarding today’s Journal of the American Medical Association article calling for the cardiology community to review and reconsider current treatment guidelines for the management of high cholesterol:

“While PCSK9 inhibitors were not available when the American College of Cardiology/American Heart Association’s current guidelines were published, the guidelines were written to accommodate new evidence-based treatments. While we await more robust outcomes data on this new class of cholesterol-lowering drugs, the ACC recommends limiting the use of PCSK9 inhibitors to only very high-risk and hard-to-treat patients,” said American College of Cardiology President Kim Allan Williams Sr., M.D., FACC.

“Other patients at risk for heart disease should consider lifestyle changes as a first step toward prevention and, if needed, statins, which are low-cost, strongly supported by evidence and effective in most patients. The potential of this new class of drugs is exciting, and we look forward to data from the clinical trials in progress that could demonstrate whether these new cholesterol-lowering drugs will benefit a wider group of patients. In the meantime, our guidelines are based on current evidence and developed through a lengthy and rigorous process; any changes to them must be supported by evidence.

“While explicit targets (e.g., an LDL of < 70 mg/dL) were not supported by the best evidence for prevention of events, our ACC/AHA guidelines target the risk of having an event, which is influenced by cholesterol levels. However, the guidelines incorporate LDLc levels for initiation of therapy in 3 of the 4 designated treatment groups. This includes patients without atherosclerotic cardiovascular disease (ASCVD) who have 1) an LDLc of > 189 mg/dL; 2) an LDLc from 70 to 189 with diabetes; and 3) an LDLc of 70 to 189 with at 10-year ASCVD risk of 7.5 percent or higher.”

The American College of Cardiology is a 49,000-member medical society that is the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications. For more information, visit


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