Application of new guidelines for the primary prevention of atherosclerotic cardiovascular disease in a Korean population

Kim, N.H., So, M.S., Kang, J.G., Cho, D.S., Byrne, Christopher D., Lee, S.J. and Sung, K.C. (2015) Application of new guidelines for the primary prevention of atherosclerotic cardiovascular disease in a Korean population. Journal of Atherosclerosis and Thrombosis, 22 (3), 293-303. (doi:10.5551/jat.26682). (PMID:25284329)

Abstract

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 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.

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Contributors

Author: Christopher D. Byrne

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