TITLE:
Can the 2019 AHA/ACC Cardiovascular Guidelines Be Improved?
AUTHORS:
David S. Schade, Allen Adolphe, Matthew Bouchonville, R. Philip Eaton
KEYWORDS:
Guidelines, Diabetes, Risk/Benefit, LDL Cholesterol, LDL Goals
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.10 No.2,
February
20,
2020
ABSTRACT: The 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Diseasefor treatment of atherosclerosis in asymptomatic individuals is an advance over previously published recommendations. However, since all guidelines are based on a limited quantity of published studies and result from a consensus of experts in different fields of medicine, omissions and errors are inevitable. The present manuscript identifies four areas in these 2019 AHA/ACC guidelines that alternative approaches or changes would result in improved outcomes and reductions in atherosclerotic events. First, the goal for the reduction in the prevalence of cardiovascular disease should be total (100%) eradication of the disease. This is a feasible goal as the facilities and resources to accomplish this task are currently available. Second, guidelines should acknowledge that atherosclerosis is a reversible disease as has previously been documented by multiple studies. If reversible, then under the appropriate clinical circumstances, it is preventable. Third, the goal for LDL cholesterol reduction should be