Application of new guidelines for the primary prevention of atherosclerotic cardiovascular disease in a Korean population

Aim: we investigated the proportion of people who would qualify for statin treatment with an atherosclerotic cardiovascular disease (ascvd) 10-year risk of ≥7.5% and who exhibit an ldl cholesterol (ldl-c) of 70 to 189 mg/dl according to the new acc/aha guidelines for the treatment of increased cardiovascular risk. methods: the study population (8,742 subjects) included individuals who underwent health examinations at kangbuk samsung hospital in south korea in 2010. we also evaluated the data obtained from the 2008-2010 korea national health and nutrition examination survey (knhanes) of 16,892 adults. results: approximately 90% of men ≥60 years of age and women ≥70 years of age had an ascvd 10-year risk of ≥7.5% and ldl-c level of ≥70 mg/dl. the proportions of subjects with a framingham 10-year risk of ≥10%,coronary artery calcium score of >20 and >100 and fatty liver each increased in association with an increasing ascvd 10-year risk quartile in both sexes. furthermore,age was significantly associated with the ascvd 10-year risk in both sexes (all p-value <0.001). the knhanes data also showed that over 85.0% of men ≥60 years of age and 95.0% of women ≥70 years of age had an ascvd 10-year risk of ≥7.5% and an ldl-c level of ≥70 mg/dl. conclusions: adopting the new ascvd prevention guidelines would result in the treatment of almost all korean men and women (≥60 years and ≥70 years of age,respectively) without evidence of cardiovascular disease. therefore,asian-specific guidelines are needed to avoid unnecessary over treatment in an aging global population. © 2015 japan atherosclerosis society.