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BLOG: New prevention guidelines a focus at AHA conference
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DALLAS — As a Dallas native, I was very excited to learn that the AHA 2013 Scientific Sessions were coming to my hometown. An aspiring preventive cardiologist, I was equally excited about the release of the new prevention guidelines — more than 5 years in development — just prior to the sessions. While my stay with family in Dallas has exceeded my excitement, I believe the new guidelines, while generating incredible excitement, are disappointing.
I was fortunate to attend the last four AHA Scientific Sessions, but this year marks the first that I was able to watch my 6-year-old niece’s soccer game — the clear highlight of the sessions for me (her team won 6-1). Additionally, the sessions provide a great opportunity to meet old friends, network with new collaborators and explore the latest science (or guidelines, in this case).
Parag H. Joshi
There is no doubt that the buzz in the hallways and over dinners with colleagues is the release of the long-awaited updated prevention guidelines. Conversations have ranged from the complicated political history of the guidelines committee (previously managed by the NHLBI under the ATP IV title for 4 years before leaving the project to the AHA/American College of Cardiology; major societies like the National Lipid Association have not endorsed the guidelines) to considerations of the biology of atherosclerosis and CVD with the abandonment of LDL cholesterol targets.
Perhaps more importantly, the debate over the guidelines and potential changes in practice that may result have led to significant media coverage, which has generated confusion among many thought leaders in the field. A piece in The New York Times on Monday, Nov. 18, focused on significant concerns over the new risk-assessment calculator that were raised by Paul M. Ridker, MD, and Nancy R. Cook, ScD, of Harvard Medical School.
The guidelines are meant to help the busy clinical practitioner. The jury is still out on whether this will be the case.
Ultimately, implementation of the best medicine is the goal. Right now, there is a struggle to come to an agreement on what the best practice is, and there is risk for significant confusion among the providers that we are intending to guide. A session on Wednesday will focus on the new guidelines; it promises to be a lively and well-attended discussion. I am hopeful that through thoughtful debate, the strategy for implementation of the guidelines can be agreed upon so that we can avoid losing credibility with the public and the practitioner.
Parag H. Joshi, MD, is a clinical fellow at The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. He can be reached at The Johns Hopkins Division of Cardiology, 600 N. Wolfe St./Carnegie 568, Baltimore, MD 21287; email: pjoshi9@jhmi.edu.
Disclosure: Joshi reports no relevant financial disclosures.