Non-Traditional Markers of Cardiovascular Disease Risk Can Improve the 2013 ACC/AHA Prevention Guidelines: Insights From the MESA Investigation
The ability to accurately identify individuals at increased risk for a cardiovascular (CV) event is critical to efficient heart disease and stroke prevention. Since the publication of the results of the LRC-CPPT in 1984 attempts to establish guidelines useful in the identification of patients who would receive the most primary cardiovascular disease (CVD) prevention benefit from blood cholesterol reduction, has been debated1. Recently the debate has expanded to suggest that reduction of the atherosclerotic CVD (ASCVD) risk threshold from the ACC/AHA 2013 suggested 7.5% to a lower 3.0%, would reduce CVD events even further and be cost effective2,3. Population wide recommendations make public health sense but fail to address the heterogeneity of this disease and the need to personalize both diagnosis and treatment. The concept that one set of guidelines is best for all individuals is woefully outdated in the current age of sophisticated metabolomics and genetics.
- Received July 19, 2015.
- Accepted July 21, 2015.