Clinical Preventive Service Recommendation
Lipid Disorders, Adults
Grade: B Recommendation
Adults 40-75 years with no symptoms or history of CVD and a calculated 10-year CVD event risk of 10% or greater
The AAFP recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: 1) they are aged 40 to 75 years; 2) they have one or more CVD risk factors (i.e., dyslipidemia, diabetes, hypertension, or smoking); and 3) they have a calculated 10-year risk of a cardiovascular event of 10% or greater.
Identification of dyslipidemia and calculation of 10-year CVD event risk requires universal lipids screening in adults ages 40 to 75 years.
See Clinical Considerations(www.uspreventiveservicestaskforce.org) for more information on lipids screening and the assessment of cardiovascular risk. (2016)
Grade: C Recommendation
Adults 40-75 years with no symptoms or history of CVD and a 10-year CVD event risk of 7.5%-10%
Although statin use may be beneficial for the primary prevention of CVD events in some adults with a 10-year CVD event risk of less than 10%, the likelihood of benefit is smaller because of a lower probability of disease and uncertainty in individual risk prediction. Clinicians may choose to offer a low- to moderate-dose statin to certain adults without a history of CVD when all of the following criteria are met: 1) they are aged 40 to 75 years; 2) they have one or more CVD risk factors (i.e., d dyslipidemia, diabetes, hypertension, or smoking); and 3) they have a calculated 10-year risk of a cardiovascular event of 7.5% to 10%. (2016)
Grade: I Recommendation
Adults 76 years and older with no history of CVD
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms of initiating statin use for the primary prevention of CVD events and mortality in adults 76 years and older without a history of heart attack or stroke. (2016)
Lipid Disorders, Children and Adolescents 20 Years or Younger
Grade: I Recommendation
The AAFP concludes that the current evidence is insufficient to assess the balance of benefits and harms for screening of lipid disorders in children and adolescents 20 years or younger. (2016)
These recommendations are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute for the individual judgment brought to each clinical situation by the patient's family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These recommendations are only one element in the complex process of improving the health of America. To be effective, the recommendations must be implemented.