Increases in statin eligibility to reduce cardiovascular risk according to the 2013 ACC/AHA cholesterol guidelines in the Africa Middle East region: a sub-analysis of the Africa Middle East Cardiovascular Epidemiological (ACE) study
Date
2019-03
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: With development of cholesterol management guidelines by the American College of Cardiology/
American Heart Association (ACC/AHA), more individuals at risk of cardiovascular disease may be eligible for statin
therapy. It is not known how this affects statin eligibility in the Africa and Middle East Region.
Methods: Data were used from the Africa Middle East Cardiovascular Epidemiological (ACE) study. The percentage
of subjects eligible for statins per the ACC/AHA 2013 cholesterol guidelines and the 2002 National Cholesterol
Education Program-Adult Treatment Panel (NCEP-ATP III) recommendations were compared. Analyses were carried out
according to age, gender, community (urban/rural), and country income categories based on World Bank definitions.
Results: According to the ACC/AHA recommendations, 1695 out of 4378 subjects (39%; 95% confidence interval [CI],
37–40%) satisfied statin eligibility criteria vs. 1043/4378 (24%; 95% CI, 23–25%) per NCEP-ATP recommendations,
representing a 63% increase in statin eligibility. Consistent increases in eligibility for statin therapy were seen according
to the ACC/AHA vs. NCEP-ATP guidelines across sub-groups of age, gender, community, and country income. Notable
increases for statin eligibility according to ACC/AHA vs. NCEP-ATP were seen, respectively, in subjects aged ≥65 years
(86% vs. 39%), in males (46% vs. 25%), in low-income countries (28% vs. 14%), and rural communities (37% vs. 19%).
Conclusion: An increase in statin eligibility was seen applying ACC/AHA cholesterol guidelines compared with
previous NCEP-ATP recommendations in the Africa Middle East region. The economic consequences of these guideline
recommendations will need further research.
Description
Keywords
Africa Middle East region, Cholesterol guidelines, Lipid-lowering therapy, Income, The Africa and Middle East Cardiovascular Epidemiological (ACE) study, Statin therapy
Citation
Hamoui, O., Omar, M. I., Raal, F. J., Rashed, W., Kane, A., Alami, M., Abreu, P., Mashhoud, W., & Alsheikh-Ali, A. A. (2019). Increases in statin eligibility to reduce cardiovascular risk according to the 2013 ACC/AHA cholesterol guidelines in the Africa Middle East region: a sub-analysis of the Africa Middle East Cardiovascular Epidemiological (ACE) study. BMC cardiovascular disorders, 19(1), 61. https://doi.org/10.1186/s12872-019-1034-2