Low Threshold for 10-Year Risk of Cardiovascular Disease Might Be Appropriate for Statin Treatment

The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend statins for primary prevention of atherosclerotic disease (ASCVD) in four patient categories (NEJM JW Gen Med Dec 15 2013 and J Am Coll Cardiol 2014; 63:2889). One of these categories is defined as patients with 10-year ASCVD risk of ≥7.5%. Considerable criticism has been levied for what seems to be a low threshold (about half of all adults are eligible for statin treatment under this guideline), but this simulation study suggests that an even lower threshold could be cost-effective.

Using well-known risk equations from the Framingham study, the modelers used national risk-factor databases; standard U.S. actuarial tables; data-based estimates of…