Which guidelines from North America and Europe on cardiovascular risk management with statins have high utility in family medicine?

objectiveTo comprehensively assess the relevance, trustworthiness, and utility of guidelines using the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST); and to describe the variability in data interpretation among guidelines on cardiovascular risk prevention, including recommendations on the management of cholesterol levels with statins in primary or secondary prevention in general practice, and indications for treatment initiation (based on cardiovascular risk scores or low-density lipoprotein [LDL] level thresholds) and for follow-up (LDL targets, a percentage reduction in LDL levels, or no target). DATA SOURCES: A literature search for guidelines on cardiovascular risk management published between January 2018 and December 2023 in primary care and secondary care. The PubMed database was used. STUDY SELECTION: Any guidelines that were not focused on a specific population and that were not simply repeating others' work were selected. SYNTHESIS: Two of 10 guidelines (ie, the Patients, Experience, Evidence, Research [PEER] and Veterans Affairs-Department of Defense [VA-DOD] guidelines) were considered "useful" by the G-TRUST evaluation and concordant in their recommendations based on high-quality evidence in a transparent process. Based on patients' overall cardiovascular risk, guidelines recommend-in primary prevention-shared decision making before initiating and titrating treatment, and they do not advocate reaching an LDL target. For secondary prevention, both guidelines recommend prescribing high-dose statin therapy without a target.

conclusionThe G-TRUST tool helps general practitioners evaluate the PEER and VA-DOD guidelines as the most relevant and rigorously developed guidelines on cardiovascular risk management (dyslipidemia) with statins.