New guidelines on treatment of blood cholesterol: too much of a good thing?

Cardiovascular disease is a leading cause of mortality around the globe. The atherosclerotic disease is a systemic chronic condition that begins in early childhood and progresses throughout adulthood. Since atherosclerosis is a preventable condition and is largely caused by accumulation of cholesterol in the arteries, the treatment of hypercholesterolemia is one of the mainstay in primary and secondary prevention. According to the new guidelines of the American College of Cardiology and American Heart Association (ACC/AHA), which substantially revise those previously published by the National Cholesterol Education Program (NCEP), statin treatment should be extended to all individuals with low density lipoprotein (LDL) cholesterol ≥70 mg/dL (1.81 mmol/L), presence of diabetes or cardiovascular risk ≥10 years 7.5%, thus generating a number of important clinical (i.e., increased number of subjects at risk of statin-related myopathy) and economic (incremental cost of the drugs) consequences, that will be discussed in this article.