Table 3

Summary of recommendations

GuidelineStatin medicationCholesterol targetsFrequency of monitoring
RecommendationLoESoRRecommendationLoESoRRecommendationLoESoR
ACD≤75 year: high-intensity statins
>75 year: initiate moderate or high-intensity statins if benefit–risk ratio favourable
A
B
I
IIa
Fasting lipids 4–12 weeks after initiation, then every 3–12 monthsAI
AUSSAtherosclerotic: high-intensity statins if reasonable life expectancyHighStrong
AUSTStatinsLDL-C <1.8 mmol/L
Or LDL-C >50% reduction
Non-HDL-C<2.6 mmol/L




CCSGModerate/high-intensity statinsHighStrongLDL-C <2.0 mmol/L
Or LDL-C >50% reduction
Alternatively, apoB <0.8 g/L
Or non-HDL-C<2.6 mmol/L
ACS: LDL-C <1.8 mmol/L
Or LDL-C >50% reduction
Mod
Mod
Mod
Mod

Strong
Strong
Strong
Strong
V&Ps
V&Ps
Until stablePO
CSNIschaemic: high-intensity statinsAILDL-C <1.8 mmol/L
Or LDL-C ≥50% reduction
B
B
II
II
ESCEASBaseline LDL-C
>1.4 mmol/L: offer med
<1.4 mmol/L: consider med
A
A
I
IIa
LDL-C <1.4 mmol/L
Or LDL-C >50% reduction
Further event <2 years:
LDL-C <1.0 mmol/L
A
A
B
I
I
IIb
Starting/adjusting: 8 (±4) weeks
Once achieved: Annually


ESVSStatins prior to endarterectomy or stentingAI--
HKCTFHigh-intensity statinsLDL-C <1.8 mmol/L
Or LDL-C >50% reduction if baseline 1.8-3.5 mmol/L


IASMaximal statinsLDL-C <1.8 mmol/L.
Non-HDL-C<2.6 mmol/L


IDFStatinsRCTriglyceride <2.3 mmol/L
HDL-C >1.0 mmol/L.
Non-HDL-C<2.5 mmol/L
LDL-C <1.8 mmol/L



RC
RC
RC
RC
At least annuallyRC
JASStatins1+ALDL-C <2.6 mmol/L
Or LDL-C >50% reduction if target cannot be met
If additional conditions:
LDL-C <1.8 mmol/L
If triglyceride high:
Non-HDL-C<3.4 mmol/L
Non-HDL-C<2.6 mmol/L if additional conditions
3
3


A
A


Regular blood testing
Every 3–6 months

B
JBS3Atorvastatin, up to 80 mg in ACSLDL-C <2.0 mmol/L
Non-HDL-C<2.5 mmol/L


Annual non–fasting TC and HDL–C once stable
NHFHighest tolerated dose of statins1AStrongLDL-C ≤1.8 mmol/LTC and LDL–C approx. 3 months after starting
NICEAtorvastatin 80 mg, lower dose if not tolerated.StrongNon-HDL-C>40% reductionStrong3 months after treatment start.
Annual non–fasting lipids

Strong
Weak
NLAModerate/high-intensity statinsHighANon-HDL-C<2.6 mmol/L
LDL-C <1.8 mmol/L
High
High
A
A
4–12 months once achievedLowE
NZStatinsLDL-C 1.6-1.8 mmol/LNon–fasting 6–12 months until target achieved.
Annually.


SAFAtherosclerotic and TC >3.5 mmol/L: statins
Trial strength, for example, 40 mg simvastatin
I
A
SAHAHigh-intensity statinsLDL-C <1.8 mmol/L
Or LDL-C >50% reduction if baseline 1.8-3.5 mmol/L


Starting/adjusting: 8 (±4) weeks
Once achieved: 6 months


SAMStatinsLDL-C <2.6 mmol/L
SIGNAtorvastatin 80 mg
Lower if not tolerated

Strong
GP
Annual ReviewGP
SMHStatins1++ALDL-C <2.1 mmol/L1++AAnnuallyGP
TSCStatinsAILDL-C <1.8 mmol/L
Diabetes: LDL-C <1.4 mmol/L
B
B
I
IIa
  • ACD, American College of Cardiology/American Heart Association/American Association of Cardiovascular and Pulmonary Rehabilitation/American Association Academy of Physician Assistants/Association of Black Cardiologists/American College of Preventive Medicine/American Diabetes Association/American Geriatrics Society/American Pharmacists Association/American Society for Preventive Cardiology/National Lipid Association/Preventive Cardiovascular Nurses Association; ACS, acute coronary syndromes; AUSS, Australia Stroke Society; AUST, Austrian Obesity Association/Austrian Atherosclerosis Society/Austrian Diabetes Association/Austrian Society of Hypertension/Austrian Society for Internal Angiology/Austrian Society of Nephrology/Austrian Society of Cardiology/Austrian Stroke Society; CCSG, Canadian Cardiovascular Society; CSN, Chinese Society of Neurology and Cerebrovascular Disease Group; ESCEAS, European Society of Cardiology and European Atherosclerosis Society; ESVS, European Society for Vascular Surgery; GP, good practice; ; (non) HDL-C, (non) HDL-cholesterol; HKCTF, Hong Kong Cardiovascular Task Force ; IAS, International Atherosclerosis Society; IDF, International Diabetes Federation; JAS, Japan Atherosclerosis Society; JBS3, Joint British Societies ; LDL-C, LDL cholesterol; LoE, level of evidence; Med, medication; Mod, moderate; NHF, National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand; NICE, National Institute for Health and Clinical Excellence; NLA, National Lipid Association; NZ, New Zealand Ministry of Health; PO, panel opinion; RC, recommended care; SAF, South African Stroke Society; SAHA, South African Heart Association; SAM, Sociedade Brasileira de Cardiologia; SIGN, Scottish Intercollegiate Guidelines Network; SMH, Singapore Ministry of Health; SoR, strength of recommendation; TC, total cholesterol; TSC, Taiwan Society of Cardiology/Taiwan Society of Emergency Medicine/Taiwan Society of Cardiovascular Interventions; V&Ps, values and preferences.