Application of New Guidelines for the Primary Prevention of Atherosclerotic Cardiovascular Disease in a Korean Population

Nan Hee Kim, Min-Suk So, Jeong-Gyu Kang, Dong-sik Cho, Christopher D Byrne, Sang Jong Lee, Ki-Chul Sung
2015 Journal of atherosclerosis and thrombosis  
Aim: We investigated the proportion of people who would qualify for statin treatment with an atherosclerotic cardiovascular disease (ASCVD) 10-year risk of ≥ 7.5% and who exhibit an LDL cholesterol (LDL-C) of 70 to 189 mg/dL according to the new ACC/AHA guidelines for the treatment of increased cardiovascular risk. Methods: The study population (8,742 subjects) included individuals who underwent health examinations at Kangbuk Samsung Hospital in South Korea in 2010. We also evaluated the data
more » ... valuated the data obtained from the 2008-2010 Korea National Health and Nutrition Examination Survey (KNHANES) of 16,892 adults. Results: Approximately 90% of men ≥ 60 years of age and women ≥ 70 years of age had an ASCVD 10-year risk of ≥ 7.5% and LDL-C level of ≥ 70 mg/dL. The proportions of subjects with a Framingham 10-year risk of ≥ 10%, coronary artery calcium score of 20 and 100 and fatty liver each increased in association with an increasing ASCVD 10-year risk quartile in both sexes. Furthermore, age was significantly associated with the ASCVD 10-year risk in both sexes (all p-value 0.001). The KNHANES data also showed that over 85.0% of men ≥ 60 years of age and 95.0% of women ≥ 70 years of age had an ASCVD 10-year risk of ≥ 7.5% and an LDL-C level of ≥ 70 mg/dL. Conclusions: Adopting the new ASCVD prevention guidelines would result in the treatment of almost all Korean men and women (≥ 60 years and ≥ 70 years of age, respectively) without evidence of cardiovascular disease. Therefore, Asian-specific guidelines are needed to avoid unnecessary over treatment in an aging global population. J Atheroscler Thromb, 2015; 22: 293-303.
doi:10.5551/jat.26682 pmid:25284329 fatcat:ngj2vatoprfwfjzex42ljvjxvu