Prevention & lipidsCohort study
Comparison of the European and US guidelines for lipid-lowering therapy in primary prevention of cardiovascular disease
- Prospective cohort study
Authors' conclusion
Both the 2022 USPSTF and 2021 ESC guidelines particularly reduced lipid-lowering therapy eligibility in women. Nearly half of women who faced an incident ASCVD were not eligible for lipid-lowering therapy.
Study context
- Population
- CoLaus|PsyCoLaus participants without atherosclerotic cardiovascular disease (ASCVD) and not taking lipid-lowering therapy at baseline158 (3.9%) incident ASCVD
- Participants
- 4,092 participants
- Exposure
- 2016 European Society of Cardiology (ESC) vs 2021 ESC vs 2019 AHA/ACC vs 2022 US Preventive Services Task Force (USPSTF)
- Outcome
- Eligibility for lipid-lowering therapy by guideline; discrimination and calibration of risk models for first incident ASCVD
- Follow-up
- Median 9 years
Main finding
As reported in the abstract
Lipid-lowering therapy recommended or considered
| Group | Women | Men |
|---|---|---|
| 2016 ESC | 40.2% (95% CI 38.2-42.2) | 62.1% (59.8-64.3) |
| 2021 ESC | 26.4% (24.6-28.2) | 58.7% (56.4-61.0) |
| 2019 AHA/ACC | 28.6% (26.7-30.5) | 52.6% (50.3-54.9) |
| 2022 USPSTF | 22.6% (20.9-24.4) | 48.4% (46.1-50.7) |
Observational data: associations, not effects.
Further findings
Women with incident ASCVD not eligible for lipid-lowering therapy at baseline
Original publication
Comparison of the European and US guidelines for lipid-lowering therapy in primary prevention of cardiovascular disease. Eur J Prev Cardiol. Published 8 June 2023. doi:10.1093/eurjpc/zwad193
Summarised from the published abstract; every number is checked against it