Lipid Management Guidelines from the Departments of Veteran Affairs and Defense: A Critique

Catherine S. Bennet, Chanukya R. Dahagam, Salim S. Virani, Seth Martin, Roger S Blumenthal, Erin Donnelly Michos, John W. McEvoy

Research output: Contribution to journalArticle

Abstract

In December 2014, the US Department of Veterans Affairs and Department of Defense (VA/DoD) published an independent clinical practice guideline for the management of dyslipidemia and cardiovascular disease risk, adding to the myriad of recently published guidelines on this topic. The VA/DoD guidelines differ from major US guidelines published by the American College of Cardiology/American Heart Association in 2013 in the following ways: recommending moderate-intensity statins for the majority of patients with statin indications regardless of atherosclerotic cardiovascular disease risk; advocating for limited on-treatment lipid monitoring; and deemphasizing ancillary data, such as coronary artery calcium testing, to improve atherosclerotic cardiovascular disease risk estimation. In the context of manifold treatment recommendations from numerous guideline committees, the VA/DoD recommendations may generate further confusion and mixed messages among healthcare providers about the optimal treatment of dyslipidemia. In this review, we critically appraise the VA/DoD recommendations with a focus on the evidence base for each area where the VA/DoD guidelines differ from the American College of Cardiology/American Heart Association guidelines. We also call for harmonization of lipid treatment guidelines to ensure high-quality and consistent care for patients with, and at risk for, atherosclerotic cardiovascular disease.

Original languageEnglish (US)
JournalAmerican Journal of Medicine
DOIs
StateAccepted/In press - 2016

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Keywords

  • Atherosclerotic cardiovascular disease
  • Coronary artery calcium
  • Dyslipidemia
  • Guidelines
  • Veterans Affairs

ASJC Scopus subject areas

  • Medicine(all)

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