A story in today’s New York Times raises concerns about the new AHA/ACC Guideline for the Assessment of Cardiovascular Risk which offers a new and improved approach to estimating a patient’s 10-year risk of developing atherosclerotic cardiovascular disease (ASCVD).

With 1 in 3 Americans dying of cardiovascular diseases and stroke, there is a critical need to improve prevention. For this reason, the ACC and AHA stand behind the new guideline and related tools, the process in which they were created and the degree to which they were approved by the panel of experts.

Among the major changes, the guideline, for the first time ever, focuses on estimating risk for both heart attacks AND strokes, whereas previous guidelines only focused on heart attack risk. The guideline also provides estimates applicable to African Americans.  “The ability to estimate risk for a more broadly based ASCVD outcome that is more relevant to contemporary populations, especially women and African Americans, and the ability to provide risk estimates specific to African Americans, are the major advances of this approach,” the Expert Panel writes.

Both the guideline and the risk calculator are based on the best evidence available as determined by the expert panel. That being said, the resulting discussions raised by the Times article are important ones for all of us to have as we move forward with tracking patients and reviewing new evidence and research over time. Science is an evolutionary process and there is no doubt, as with all guidelines and tools, that new science will lead to updates and improvements.

In the meantime, the guideline and risk calculator are doing exactly what they are intended to do – starting a discussion between patients and their providers about individual risks for cardiovascular disease and stroke and appropriate treatment options. Guidelines are developed to guide physicians in making the best choices for their patients based on the latest evidence. They are never intended to replace sound clinician judgment. At the end of the day, the new risk assessment guideline, as well as the other three prevention guidelines, provide important recommendations that will only serve to benefit patients, providers and the broader public health as we continue to take on the nation’s #1 killer – cardiovascular disease.

Also read a joint press release from ACC and AHA and a commentary from Harlan Krumholz, MD, FACC, on “What to Know About the New Lipid Guidelines.”

 

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