Lipid Management Guidelines from the Departments of Veteran Affairs and Defense: A Critique [Review]
Citation: American Journal of Medicine. 129(9):906-12, 2016 SepPMID: 27154781Institution: MedStar Franklin Square Medical CenterDepartment: MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Dyslipidemias/pc [Prevention & Control] | *Hydroxymethylglutaryl-CoA Reductase Inhibitors/tu [Therapeutic Use] | *Practice Guidelines as Topic | *United States Department of Defense/st [Standards] | *United States Department of Veterans Affairs/st [Standards] | Biomarkers/an [Analysis] | Calcium/an [Analysis] | Cardiovascular Diseases/pc [Prevention & Control] | Coronary Vessels/ch [Chemistry] | Humans | Hydroxymethylglutaryl-CoA Reductase Inhibitors/ad [Administration & Dosage] | Lipids/bl [Blood] | United StatesYear: 2016Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - presentISSN:- 0002-9343
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 27154781 | Available | 27154781 |
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - present
Copyright © 2016 Elsevier Inc. All rights reserved.
In December 2014, the US Department of Veterans Affairs and Department of Defense (VA/DoD) published an independent clinical practice guideline for the management of dyslipidemia and cardiovascular disease risk, adding to the myriad of recently published guidelines on this topic. The VA/DoD guidelines differ from major US guidelines published by the American College of Cardiology/American Heart Association in 2013 in the following ways: recommending moderate-intensity statins for the majority of patients with statin indications regardless of atherosclerotic cardiovascular disease risk; advocating for limited on-treatment lipid monitoring; and deemphasizing ancillary data, such as coronary artery calcium testing, to improve atherosclerotic cardiovascular disease risk estimation. In the context of manifold treatment recommendations from numerous guideline committees, the VA/DoD recommendations may generate further confusion and mixed messages among healthcare providers about the optimal treatment of dyslipidemia. In this review, we critically appraise the VA/DoD recommendations with a focus on the evidence base for each area where the VA/DoD guidelines differ from the American College of Cardiology/American Heart Association guidelines. We also call for harmonization of lipid treatment guidelines to ensure high-quality and consistent care for patients with, and at risk for, atherosclerotic cardiovascular disease.
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