New worldwide lipid guidelines

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality in most countries. Modification of common risk factors such as dyslipidaemia can result in significant reduction of ASCVD incidence in the population and improve clinical outcomes. The purpose of this review is to discuss and compare the latest worldwide lipid guidelines, and to demonstrate the variation in practice in different parts of the world.

The lipid guidelines have recently been updated in different countries. The National Institute for Health and Care Excellence (NICE) guidelines in the United Kingdom were issued in July 2014, are risk based and are broadly similar to the American College of Cardiology/American Heart Association task force guidelines that were published in November 2013. Both these guidelines are in variance with both the Canadian Guidelines and the European Society of Cardiology/European Atherosclerosis Society guidelines 2011, which are target based and have different risk scoring systems, which results in significant variation in practice and increased healthcare costs in certain countries.

The difference in guidelines in different countries makes it difficult for the clinician to standardize the treatment provided to individuals. The variance in risk scoring systems makes it difficult to compare risk prediction tools across countries and hence the optimum treatment available for a given population. Standardization of guidelines based on randomized controlled trial data and validation and calibration of various risk scoring systems could help improve clinical outcomes in this high-risk group of individuals at risk of ASCVD within individual countries.