One of the nation’s leading clinical endocrinology associations is rejecting the new cholesterol and obesity guidelines issued by the American Heart Association and the American College of Cardiology in November, saying that the already-controversial new risk calculator is outdated and that the guidelines are incompatible with the association’s existing guidelines.
"Additionally, there are questions and concerns regarding the scientific basis for these new guidelines and the populations of patients at risk from disease who are underserved or ill-considered in these new strategies," the American Association of Clinical Endocrinologists (AACE) said in a statement to the press issued Dec. 23, nearly a month after it was released to its members.
The ACC and AHA released new cardiovascular disease prevention guidelines focused on cholesterol treatment, assessment of cardiovascular risk, lifestyle management, and management of overweight and obesity.
The cholesterol management guidelines quickly became controversial, especially after two Harvard researchers questioned the validity of the new Cardiovascular Risk Calculator.
AACE too has taken issue with the risk calculator, saying that it’s "already outdated," and that "it is based upon outmoded data, does not model the totality of the U.S. population, has not been validated, and therefore has only limited applicability."
The association said in its statement that it agreed with the use of full-dose statins, but disagreed with removing low-density lipoprotein (LDL) goals and the notion that statin therapy alone is sufficient for all at-risk patients.
AACE is not alone in declining to endorse the new cholesterol guidelines. In a separate statement earlier, the National Lipid Association took issue with removing LDL goals, saying it did “not find evidence-based support for the Panel’s recommendation for removing LDL-C (and non-HDL-C) treatment targets.”
ACC and AHA leaders called a last-minute press conference during the AHA’s annual meeting in Dallas in November, defending the cholesterol guidelines and the new risk calculator.
AACE also says that the new obesity guidelines are limited in their scope and do not include data after 2011. “These new guidelines fail to classify obesity as a disease and continue the paradigm of BMI-centric risk stratification, both of which are contrary to recently stated AACE positions.”
AACE said that the new ACC/AHA guidelines “are now among many available guidelines, including the AACE lipid guidelines, to which clinicians can refer.”
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