The guideline process plays an essential role in medical care, and none is more prestigious
or influential than the AHA/ACC Multisociety Cholesterol Guidelines. Their recommendations
govern medical care in the United States within the areas they cover. The present
report is the latest in a sequence in which each has built on its predecessor. The
breadth of organizations that have participated in this process is impressive. The
extraordinary contributions to improvement of cardiovascular care are unquestionable.
Nevertheless, no matter how apparently impeccable their processes or how accomplished
their membership, that does not guarantee—as I will try to demonstrate—that they get
everything right.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Clinical LipidologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol.Circulation. 2018; 10 (CIR0000000000000625)
- A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk.Circ Cardiovasc Qual Outcomes. 2011; 4: 337-345
- Correlation of non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol with apolipoprotein B during simvastatin + fenofibrate therapy in patients with combined hyperlipidemia (a subanalysis of the SAFARI trial).Am J Cardiol. 2009; 104: 548-553
- Differential response of cholesterol and particle measures of atherogenic lipoproteins to LDL-lowering therapy: implications for clinical practice.J Clin Lipidol. 2008; 2: 36-42
- Phenotypes of hypertriglyceridemia caused by excess very-low-density lipoprotein.J Clin Lipidol. 2012; 6: 427-433
- Comparisons of apolipoprotein B levels estimated by immunoassay, nuclear magnetic resonance, vertical auto profile, and non-high-density lipoprotein cholesterol in subjects with hypertriglyceridemia (SAFARI Trial).Am J Cardiol. 2011; 108: 40-46
- Apolipoprotein B and cardiovascular disease risk: position statement from the AACC Lipoproteins and Vascular Diseases Division Working Group on Best Practices.Clin Chem. 2009; 55: 407-419
- Association of apolipoprotein B and nuclear magnetic resonance spectroscopy-derived LDL particle number with outcomes in 25 clinical studies: assessment by the AACC lipoprotein and vascular diseases division working group on best practices.Clin Chem. 2013; 59: 752-770
- Quantifying atherogenic lipoproteins: current and future challenges in the era of personalized medicine and very low concentrations of LDL Cholesterol. A consensus statement from EAS and EFLM.Clin Chem. 2018; 64: 1006-1033
- A comparison of three apolipoprotein B methods and their associations with incident coronary heart disease risk over a 12-year follow-up period: the Multi-ethnic study of atherosclerosis.J Clin Lipidol. 2018; 12: 300-304
- A failure of standardization or a failure of the process of standardization.J Clin Lipidol. 2018; 12: 1325-1326
- Apolipoprotein B measurement: need for standardization.J Clin Lipidol. 2018; 12: 264-265
- Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile.JAMA. 2013; 310: 2061-2068
- Rapid isolation of low density lipoprotein (LDL) subfractions from plasma by density gradient ultracentrifugation.Atherosclerosis. 1990; 83: 59-67
- National Health and Nutrition Examination Survey (Nhanes).CreateSpace, 2014 (NHANESdataset)http://www.cdc.gov/nchs/data/nhanes/nhanes_03_04/nhanes_analytic_guidelines_dec_2005.pdfDate accessed: April 22, 2013
- The central role of arterial retention of cholesterol-rich apolipoprotein-B-containing lipoproteins in the pathogenesis of atherosclerosis: a triumph of simplicity.Curr Opin Lipidol. 2016; 27: 473-483
- Identification of a danger-associated peptide from apolipoprotein B100 (ApoBDS-1) that triggers innate proatherogenic responses.Circulation. 2011; 124 (1–7): 2433-2443
- ApoB-containing lipoproteins regulate angiogenesis by modulating expression of VEGF receptor 1.Nat Med. 2012; 18: 967-973
- Oxidized phospholipids are proinflammatory and proatherogenic in hypercholesterolaemic mice.Nature. 2018; 558: 301-306
- Concordance/discordance between plasma apolipoprotein B levels and the cholesterol indexes of atherosclerotic risk.Am J Cardiol. 2003; 91: 1173-1177
- Hypertriglyceridemia and cardiovascular risk: a cautionary note about metabolic confounding.J Lipid Res. 2018; 59: 1266-1275
- An evidence-based analysis of the National Lipid Association recommendations concerning non-HDL-C and apoB.J Clin Lipidol. 2016; 10: 1248-1258
- LDL particle number and risk of future cardiovascular disease in the Framingham Offspring Study - implications for LDL management.J Clin Lipidol. 2007; 1: 583-592
- Clinical implications of discordance between low-density lipoprotein cholesterol and particle number.J Clin Lipidol. 2011; 5: 105-113
- Discordance analysis of apolipoprotein B and non-high density lipoprotein cholesterol as markers of cardiovascular risk in the INTERHEART study.Atherosclerosis. 2012; 225: 444-449
- Discordance of low-density lipoprotein (LDL) cholesterol with alternative LDL-related measures and future coronary events.Circulation. 2014; 129: 553-561
- Apolipoprotein B improves risk assessment of future coronary heart disease in the Framingham Heart Study beyond LDL-C and non-HDL-C.Eur J Prev Cardiol. 2015; 22: 1321-1327
- Discordance between apolipoprotein B and LDL-cholesterol in young adults predicts coronary artery calcification: the CARDIA Study.J Am Coll Cardiol. 2016; 67: 193-201
- Discordance between circulating atherogenic cholesterol mass and lipoprotein particle concentration in relation to future coronary events in women.Clin Chem. 2017; 63: 870-879
- Non-HDL cholesterol and apoB in dyslipidaemia.Clin Sci (Lond). 2008; 114: 149-155
- Relations of change in plasma levels of LDL-C, non-HDL-C and apoB with risk reduction from statin therapy: a meta-analysis of randomized trials.J Am Heart Assoc. 2014; 3: e000759
- Impact of Novel LDL-C assessment on the utility of secondary Non-HDL-C and ApoB targets in selected worldwide dyslipidemia guidelines.Circulation. 2018; 138: 244-254
- Association of genetic variants related to CETP inhibitors and statins with lipoprotein levels and cardiovascular risk.JAMA. 2017; 318: 947-956
- Association of triglyceride-lowering LPL variants and LDL-C-Lowering LDLR variants with risk of coronary heart disease.JAMA. 2019; 321: 364-373
- Hyperlipoproteinemia type 3: the forgotten phenotype.Curr Atheroscler Rep. 2014; 16: 440
- Dysbetalipoproteinemia: an extreme disorder of remnant metabolism.Curr Opin Lipidol. 2015; 26: 292-297
- The spectrum of type III hyperlipoproteinemia.J Clin Lipidol. 2018; 12: 1383-1389
- Screening for dysbetalipoproteinemia by plasma cholesterol and apolipoprotein B concentrations.Clin Chem. 2005; 51: 904-907
- Evaluation of the Non-HDL cholesterol to apolipoprotein B ratio as a screening test for dysbetalipoproteinemia.Clin Chem. 2019; 65: 313-320
- Diagnosis of type III hyperlipoproteinemia from plasma total cholesterol, triglyceride, and apolipoprotein B.J Clin Lipidol. 2007; 1: 256-263
- Quantifying importance of major risk factors for coronary heart disease.Circulation. 2018; 139: 1603-1611
Article info
Footnotes
Conflict of interest: None.
Identification
Copyright
© 2019 Published by Elsevier Inc. on behalf of National Lipid Association.
