What to say and how to say it: Effective communication for cardiovascular disease prevention

Purpose of review Current guidelines for cholesterol treatment emphasize the importance of engaging patients in a risk-benefit discussion prior to initiating statin therapy. Recent findings Although current risk prediction algorithms are well defined, there is less data on how to communicate with patients about cardiovascular disease risk, benefits of treatment, and possible adverse effects. Summary We propose a four-part model for effective shared decision-making: 1) Assessing patient priorities, perceived risk, and prior experience with cardiovascular risk reduction; 2) Arriving at a recommendation for therapy based on the patient's risk of disease, guideline recommendations, new clinical trial data, and patient preferences; 3) Communicating this recommendation along with risks, benefits, and alternatives to therapy following best practices for discussing numeric risk; and 4) Arriving at a shared decision with the patient with ongoing reassessment as risk factors and patient priorities change.