Low-density lipoprotein cholesterol goals: Still not in patients' best interest

Abstract

In what became a highly-publicised move, the American Heart Association (AHA) and American College of Cardiology (ACC) effectively dropped low-density lipoprotein cholesterol (LDL-C) goals from their most recent guidelines pertaining to the matter. However, due to developments since the AHA and ACC released their current guidelines, some have called for a return to focusing on LDL-C goals. This article puts forth an overview of the salient issues at hand, important evidence-based considerations, and a conclusion that shifting focus away from LDL-C goals is clearly an evidence-based step in the right direction. Indeed, careful scrutiny of the current evidence base shows returning to LDL-C goals would be a mistake, and we should focus instead on overall cardiovascular risk, medications proven to reduce patient-relevant outcomes, and shared decision-making.