New AHA/ACC Guideline Will Help to Better Manage Cardiovascular Risk and Prevent Costly Disease Complications
11.15.13 | By Salvatore Alesci
The newly released American Heart Association (AHA) and American College of Cardiology (ACC) Guidelines on the Treatment of Blood Cholesterol and Lifestyle Management to Reduce Atherosclerotic Cardiovascular Risk in Adults have received a great deal of attention over the last couple days and are certain to stimulate further discussion as physicians and patients alike integrate the new recommendations into treatment – and disease prevention – decisions. The AHA and ACC should be commended for their effort to review these guidelines, which were last updated in 2004.
While many of the media headlines to date have focused on the potential increase in statin use, looking beyond the headlines reveals the multi-faceted nature of the new guidelines, the breadth of potential positive implications for patients, and the main focus on better prevention. Key among these is the empowerment of physicians to utilize a more targeted approach to lowering LDL cholesterol (i.e., “bad cholesterol”) by focusing on early therapeutic intervention in groups of patients most likely to benefit from it.
These groups include, for example, patients with Type 2 diabetes who are between 40 and 75 years of age. Such inclusion is very timely, if you consider the latest data just released by the International Diabetes Foundation (IDF) showing that diabetes cases hit a new record in 2013, with 382 million compared to 371 million cases last year. Added to blood sugar control, LDL control in the diabetes population based on the new guidelines could help better manage some of the complications of this epidemic disease which, according to IDF, will account for $627 billion in global healthcare spending by 2035.
A couple of other interesting elements in the guidelines are worth highlighting. First, the inclusion of stroke risk can go a long way to raise awareness of the seriousness of stroke, and the need to do all we can to prevent it. We have made progress in this area through the introduction of new medicines and a greater focus on prevention. In fact, in 2008, stroke dropped to the fourth leading cause of death after being the third for more than 50 years. But more can be done and we hope that this guideline - along with new innovation (currently there are 19 medicines in development specifically for stroke) - will contribute to continued progress.
Second, the inclusion in the risk assessment algorithms of gender and ethnicity -specific formulas, derived from large community-based cohort studies such as the Framingham Heart Study and the Cardiovascular Health Study, is significant. There is evidence that gender and ethnicity play a role in affecting overall cardiovascular risk, so the new guidelines provide an opportunity for a more precise and targeted approach to risk evaluation. In addition, they may provide a vehicle to build better awareness among populations disproportionately affected by cardiovascular diseases, such as African Americans, and reduce disparities in access to effective medical treatments.
Last but not least, the new guidelines also serve as a reminder of the importance of diet, exercise, and lifestyle changes, for which medicine should not be a substitute.
Altogether, better assessment of cardiovascular risk, lifestyle changes and earlier and/or more aggressive therapeutic intervention in high-risk groups should help to reduce disease complications and hospitalizations, promote better quality of life for patients, and contribute to lower healthcare costs.
The new guidelines build on significant progress in recent years to decrease cardiovascular morbidity and mortality. It is particularly encouraging that death rates from heart disease and stroke are falling. Thanks in large part to new medicines, deaths due to these two conditions decreased by 30 percent between 2001 and 2011.
Our member companies are dedicated to improving and saving the lives of those diagnosed with or at risk for heart disease or stroke. According to the Medicines in Development report issued by PhRMA in May, biopharmaceutical research companies are studying an impressive 215 medicines to treat these conditions. Together, we will continue to build on the progress to date and help patients live longer, healthier lives.
Page last updated 11/15/13 ~ 15:49 EST