Statins for primary prevention of CVD: To start or not to start?

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That is the question. In this month’s audiocast, Doug Campos-Outcalt, MD, MPA, details 4 guidelines that diverge on the issue and uses a single patient to demonstrate the very different plans of care that would result if the 2 US guidelines were implemented.



  1. Ioannidis JPA. Inconsistent guideline recommendations for cardiovascular prevention and the debate about zeroing in on and zeroing LDL-C levels with PCSK9 inhibitors. JAMA. 2017;318:419-420. Available at:
  2. Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. J Am Coll Cardiol. 2014;63:2889-2934. Available at:
  3. Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;316:1997-2007. Available at:
  4. Catapano AL, Graham I, De Backer G, et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016;37:2999-3058. Available at:
  5. Anderson TJ, Grégoire J, Pearson GJ, et al. 2016 Canadian cardiovascular society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2016;32:1263-1282. Available at:
  6. Pagidipati NJ, Navar AM, Mulder H, et al. Comparison of recommended eligibility for primary statin therapy based on the US Preventive Services Task Force recommendations vs the ACC/AHA guidelines. JAMA. 2017;317:1563-1567. Available at:

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