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This page uses the Pooled Cohort ASCVD Risk Equations (1) and does not apply to people with known atherosclerotic cardiovascular disease or LDL-C > 190 mg/dl as these people need high-intensity statins.(2)
The facts box format was created and validated by Schwartz LM, Woloshin S, Welch HG, 2009. See citation below.
Last updates: style 2/18/2018; content 02/23/2017. Last revisions to content include option for aspirin.
Goff DC Jr, Lloyd-Jones DM, Bennett G, Coady S, D'Agostino RB Sr, Gibbons R, Greenland P, Lackland DT, Levy D, O'Donnell CJ, Robinson J, Schwartz JS, Shero ST, Smith SC Jr, Sorlie P, Stone NJ, Wilson PW. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2013. PMID: 24222018.
Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2):S1-45. doi: 10.1161/01.cir.0000437738.63853.7a. PMID: 24222016
Martin SS, Blaha MJ, Elshazly MB, Toth PP, Kwiterovich PO, Blumenthal RS, Jones SR. Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile. JAMA. 2013 Nov 20;310(19):2061-8. doi: 10.1001/jama.2013.280532. PMID: 24240933.
Taylor F, Huffman MD, Macedo AF, Moore TH, Burke M, Davey Smith G, Ward K, Ebrahim S. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013. PMID: 23440795.
Rea TD, Heckbert SR, Kaplan RC, Smith NL, Lemaitre RN, Psaty BM. Smoking status and risk for recurrent coronary events after myocardial infarction. Ann Intern Med. 2002 Sep 17;137(6):494-500. PMID: 12230350.
Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 PMID: 24222015
Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al. PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013 Apr 4;368(14):1279-90. doi: 10.1056/NEJMoa1200303. PMID: 23432189 (Details about the Mediterranean Diet).
The version of this diet in this trial reduced major cardiovascular events. This version encouraged daily either
1/4 cup (4 tablespoons) of extra virgin olive oil
30 grams of mixed nuts per day (15 g of walnuts, 7.5 g of hazelnuts, and 7.5 g of almonds). The nuts possibly conferred less benefit than the olive oil.
Another version that encourages two servings of vegetables at every meal is available.
Schwartz LM, Woloshin S, Welch HG. Using a drug facts box to communicate drug benefits and harms: two randomized trials. Ann Intern Med. 2009 Apr 21;150(8):516-27. PMID: 19221371 (This study describes development and validation of facts boxes. In addition, some of the language in the statins facts box is from this study.)
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