TITLE:
The Importance of Setting Treatment Goals for Cardiovascular Diseases
AUTHORS:
David S. Schade, Bramara Nagamallika Godasi, Teodor Duro, Robert Philip Eaton
KEYWORDS:
Guideline Goals for Cardiovascular Disease Prevention, Cardiovascular Disease, Risk Factors for Cardiovascular Disease, Pooled Cohort Equations
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.14 No.1,
January
18,
2024
ABSTRACT: Background: Guidelines are issued by most major organizations
that focus on a specific disease entity. Guidelines should be a significant
help to the practicing physician who may not be up-to-date with the recent
medical literature. Unfortunately, when conflicting guidelines for a specific
disease are published, confusion results. Purpose: This article provides a suggested guideline outcome measure that would benefit the
physician and patient. Methods: A review of 19 different guidelines for cardiovascular
disease treatment is one example of the lack of specific outcomes that currently exist. The
basic problem with most guidelines is that they do not state the expected end
result (i.e., the benefit to the
patient) if that guideline is followed. When guidelines use cardiovascular
disease risk factors to dictate therapy, the end benefit is never stated so
that the patient can make an appropriate choice of which (if any) guideline to
follow. Results: A good
example is guidelines published by the American
Heart Association for reducing cardiovascular disease. These guidelines
are risk factor based and only indicate that cardiovascular disease would be
reduced if followed. No specific percentage in the reduction of the incidence
of disease is given. In contrast, when elimination of the disease is the stated
goal of the guideline, the end result is clear. To date, this goal has been
stated by only one organization devoted to eliminating cardiovascular disease. Conclusion: Guidelines need to be written to provide the
physician and the patient with a specific end point that is expected when the
guideline is followed. Patient acceptance and compliance will be much improved
if the patient knows the risk/benefit of following the guideline’s
recommendations.