Provider understanding of the 2013 ACC/AHA cholesterol guideline

Salim S. Virani, Yashashwi Pokharel, Lynne Steinberg, Winston Chan, Julia M. Akeroyd, Saqib Ali Gowani, Ankur Kalra, Venkateshwar Polsani, Michael D. Miedema, Peter H. Jones, Vijay Nambi, Laura A. Petersen, Christie M. Ballantyne

Research output: Contribution to journalArticlepeer-review

58 Citations (Scopus)


Background Providers' understanding of the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline in clinical practice is not known. Methods We designed a questionnaire, which was administered to internal medicine, family practice, cardiology, and endocrinology providers at 21 venues across the United States. We compared responses between providers in training or practice and between specialists (cardiology and endocrinology) and nonspecialists (internal medicine and family practice). Results Response rate was 72.1% (543 of 725). About 43% of the providers in training and 48% of those in practice indicated having read the guideline. Almost 50% in each group were unable to identify the 4 statin benefit groups and a large proportion (41% in training and 49% in practice) were not aware of the ≥7.5% 10-year risk threshold for discussion regarding statin therapy. Most (∼85%) were unaware of the 4 outcomes assessed by the 10-year ASCVD risk equation. About 36% of the providers in training and 48% in practice could identify a patient with familial hypercholesterolemia and start a discussion regarding statin therapy. Only 27.6% of the providers in training and 40.4% in practice recommended repeating a lipid panel 6-8 weeks after starting statins in a patient with recent myocardial infarction. Similar gaps were noted when comparing specialists to nonspecialists. Conclusion Most providers do not completely understand the 2013 ACC/AHA cholesterol guideline. As an unintended consequence, providers are moving away from lipid testing to document response and adherence to statin therapy. Efforts are needed to address these gaps.

Original languageEnglish
Pages (from-to)497-504.e4
JournalJournal of Clinical Lipidology
Issue number3
Publication statusPublished - 1 May 2016
Externally publishedYes


  • ASCVD risk
  • Cholesterol guideline
  • Familial hypercholesterolemia
  • Practice
  • Survey


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