USPSTF Updates Guideline on Screening for Lipid Disorders in Adults

The US Preventive Services Task Force (USPSTF) has updated its landmark 2008 guideline on screening for lipid disorders in adults. The update focuses specifically on “Statin Use for the Primary Prevention of Cardiovascular Disease in Adults.” The new guideline recommends low- to moderate-dose statins in adults 40-75 years of age without a history of cardiovascular disease (CVD) who present with one or more risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of ≥ 10% using a CVD risk calculator such as the American College of Cardiology/American Heart Association calculator (grade B recommendation). The USPSTF also recommends clinicians offer low- to moderate-dose statins selectively to the same group presenting with a lower 10-year CVD event risk of 7.5-10% (grade C recommendation). There is insufficient evidence to assess the balance of benefits and harms of starting statins in adults ≥ 76 years of age. The USPSTF also believes there is insufficient evidence to make a recommendation on screening or treating adults 21-39 years of age. Recommended daily doses for low-dose treatment include lovastatin 20 mg, pravastatin 10-20 mg, and simvastatin 10 mg. Moderate doses include atorvastatin 10-20 mg, lovastatin 40 mg, pravastatin 40-80 mg, rosuvastatin 5-10 mg, and simvastatin 20-40 mg. There is insufficient evidence to recommend high-dose statins for primary prevention. (JAMA 2016;316:1997-2007)