Clinician-patient risk discussion for atherosclerotic cardiovascular disease prevention: Importance to implementation of the 2013 ACC/AHA guidelines

Seth S. Martin, Laurence S. Sperling, Michael J. Blaha, Peter W.F. Wilson, Ty J. Gluckman, Roger S. Blumenthal, Neil J. Stone

Research output: Contribution to journalReview article


Successful implementation of the 2013 American College of Cardiology/American Heart Association cholesterol guidelines hinges on a clear understanding of the clinician-patient risk discussion (CPRD). This is a dialogue between the clinician and patient about potential for atherosclerotic cardiovascular disease risk reduction benefits, adverse effects, drug-drug interactions, and patient preferences. Designed especially for primary prevention patients, this process of shared decision making establishes the appropriateness of a statin for a specific patient. CPRD respects the autonomy of an individual striving to make an informedchoice aligned with personal values and preferences. Dedicating sufficient timeto high-quality CPRD offers an opportunity to strengthen clinician-patient relationships, patient engagement, and medication adherence. We review the guideline-recommended CPRD, the general concept of shared decision making and decision aids, the American College of Cardiology/American Heart Association Risk Estimator application as an implementation tool, and address potential barriers to implementation.

Original languageEnglish (US)
Pages (from-to)1361-1368
Number of pages8
JournalJournal of the American College of Cardiology
Issue number13
StatePublished - Jan 1 2015



  • Cerebrovascular disease
  • Coronary heart disease
  • Lipid-lowering therapy
  • Myocardial infarction
  • Risk estimation
  • Shared decision making

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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