Absolute risk-based versus individualized benefit approaches for determining statin eligibility in primary prevention of cardiovascular diseases in Chinese populations: A modeling study

Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This stud...

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Vydáno v:PLoS medicine Ročník 22; číslo 7; s. e1004556
Hlavní autoři: Liu, Qiuping, Gong, Chao, Zhou, Tianjing, Zhang, Minglu, Liu, Xiaofei, Tang, Xun, Gao, Pei
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Public Library of Science 22.07.2025
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ISSN:1549-1676, 1549-1277, 1549-1676
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Abstract Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations. We analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40-80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit. The individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.
AbstractList Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations. We analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40-80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit. The individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.
Qiuping Liu and her colleagues compare the conventional, absolute, risk-based approach with an individualized, benefit-based approach that considers the effects of lipid-lowering for statin eligibility in Chinese populations.
BackgroundCurrent guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations.Methods and FindingsWe analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40–80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit.ConclusionsThe individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.
Background Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations. Methods and Findings We analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40-80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit. Conclusions The individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.
Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations. We analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40-80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit. The individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.
Background Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations. Methods and Findings We analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40–80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit. Conclusions The individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.
Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations.BACKGROUNDCurrent guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations.We analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40-80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit.METHODS AND FINDINGSWe analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40-80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit.The individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.CONCLUSIONSThe individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.
Audience Academic
Author Liu, Xiaofei
Tang, Xun
Zhou, Tianjing
Zhang, Minglu
Liu, Qiuping
Gong, Chao
Gao, Pei
AuthorAffiliation South African Medical Research Council, SOUTH AFRICA
2 Center for Real-world Evidence evaluation, Peking University Clinical Research Institute, Beijing, China
1 Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
3 Key Laboratory of Epidemiology of Major Disease, Peking University, Ministry of Education, Beijing, China
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– name: South African Medical Research Council, SOUTH AFRICA
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/40694580$$D View this record in MEDLINE/PubMed
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Cites_doi 10.1016/j.jacc.2018.11.003
10.1016/j.tcm.2019.01.001
10.1001/jama.2024.12537
10.1038/s41569-024-01039-5
10.1016/S0140-6736(10)61350-5
10.1093/eurjpc/zwae174
10.1093/eurheartj/ehab484
10.1093/eurjpc/zwad193
10.1001/jama.2022.13044
10.1001/jamacardio.2022.1883
10.1001/jamacardio.2018.3476
10.1093/ije/dys203
10.1016/S0140-6736(16)30388-9
10.1001/jamacardio.2019.2851
10.1161/JAHA.116.004316
10.1016/j.amjcard.2018.02.011
10.1007/s00134-014-3624-x
10.1001/jamacardio.2021.3508
10.1093/eurheartj/ehu004
10.1016/S0140-6736(16)31357-5
10.1016/S0140-6736(19)32008-2
10.1093/aje/kwz170
10.1016/j.jacadv.2023.100825
10.1093/eurheartj/ehac268
10.1161/CIRCULATIONAHA.121.057631
10.1136/bmj.h2622
10.1093/eurheartj/ehad539
10.1161/CIRCULATIONAHA.115.018383
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Copyright Copyright: © 2025 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
COPYRIGHT 2025 Public Library of Science
2025 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
2025 Liu et al 2025 Liu et al
2025 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Copyright_xml – notice: Copyright: © 2025 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
– notice: COPYRIGHT 2025 Public Library of Science
– notice: 2025 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
– notice: 2025 Liu et al 2025 Liu et al
– notice: 2025 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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DOI 10.1371/journal.pmed.1004556
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DocumentTitleAlternate Strategies of statin eligibility for primary prevention of CVD in Chinese
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License Copyright: © 2025 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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The authors have read the journal's policy and declare the following competing interests: P.G. reported receiving research funds from Bayer and Merck; however, the funding sources had no relation to this study. All other authors of this study have reported that they have no relationships relevant to the contents of this paper to disclose.
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References JM Bland (pmed.1004556.ref021) 2015; 350
Guideline Committee (pmed.1004556.ref001) 2023; 381
R Collins (pmed.1004556.ref035) 2016; 388
Y Zhao (pmed.1004556.ref012) 2014; 43
CN Kohli-Lynch (pmed.1004556.ref032) 2019; 4
GBJ Mancini (pmed.1004556.ref030) 2024; 45
C Li (pmed.1004556.ref013) 2021; 18
MJ Pletcher (pmed.1004556.ref019) 2017; 6
G Thanassoulis (pmed.1004556.ref010) 2016; 133
Force US Preventive Services Task (pmed.1004556.ref002) 2022; 328
SO Almeida (pmed.1004556.ref036) 2019; 29
GA Stevens (pmed.1004556.ref022) 2016; 388
MJG Leening (pmed.1004556.ref007) 2018; 15
AM Navar (pmed.1004556.ref006) 2022; 7
FLJ Visseren (pmed.1004556.ref003) 2021; 42
WHO CVD Risk Chart Working Group (pmed.1004556.ref015) 2019; 7
FHY Cesena (pmed.1004556.ref025) 2018; 121
S Yusuf (pmed.1004556.ref009) 2020; 395
G Thanassoulis (pmed.1004556.ref028) 2018; 3
CN Kohli-Lynch (pmed.1004556.ref024) 2022; 145
GJ Pearson (pmed.1004556.ref004) 2021; 37
DK Arnett (pmed.1004556.ref005) 2019; 201974
JA Diao (pmed.1004556.ref033) 2024; 332
J van der Leeuw (pmed.1004556.ref020) 2014; 35
Cholesterol Treatment Trialists’ (CTT) Collaboration (pmed.1004556.ref034) 2010; 376
C Kohli-Lynch (pmed.1004556.ref011) 2024; 3
BA Ference (pmed.1004556.ref027) 2024; 21
SHJ Hageman (pmed.1004556.ref029) 2024; 31
B Delabays (pmed.1004556.ref031) 2023; 30
S Chevret (pmed.1004556.ref023) 2015; 41
S Li (pmed.1004556.ref008) 2022; 43
X Chen (pmed.1004556.ref014) 2019; 188
J Li (pmed.1004556.ref016) 2021; 8
X-L Yang (pmed.1004556.ref017) 2016; 2
Y Zhang (pmed.1004556.ref026) 2021; 6
SM Grundy (pmed.1004556.ref018); 201973
References_xml – volume: 201973
  issue: 24
  ident: pmed.1004556.ref018
  article-title: 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the american college of cardiology/american heart association task force on clinical practice guidelines
  publication-title: J Am Coll Cardiol
  doi: 10.1016/j.jacc.2018.11.003
– volume: 29
  start-page: 451
  issue: 8
  year: 2019
  ident: pmed.1004556.ref036
  article-title: Effect of statins on atherosclerotic plaque
  publication-title: Trends Cardiovasc Med
  doi: 10.1016/j.tcm.2019.01.001
– volume: 332
  start-page: 989
  issue: 12
  year: 2024
  ident: pmed.1004556.ref033
  article-title: Projected changes in statin and antihypertensive therapy eligibility with the AHA PREVENT cardiovascular risk equations
  publication-title: JAMA
  doi: 10.1001/jama.2024.12537
– volume: 21
  start-page: 701
  issue: 10
  year: 2024
  ident: pmed.1004556.ref027
  article-title: The LDL cumulative exposure hypothesis: evidence and practical applications
  publication-title: Nat Rev Cardiol
  doi: 10.1038/s41569-024-01039-5
– volume: 376
  start-page: 1670
  issue: 9753
  year: 2010
  ident: pmed.1004556.ref034
  article-title: Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials
  publication-title: Lancet
  doi: 10.1016/S0140-6736(10)61350-5
– volume: 31
  start-page: 1690
  issue: 14
  year: 2024
  ident: pmed.1004556.ref029
  article-title: Prediction of individual lifetime cardiovascular risk and potential treatment benefit: development and recalibration of the LIFE-CVD2 model to four European risk regions
  publication-title: Eur J Prev Cardiol
  doi: 10.1093/eurjpc/zwae174
– volume: 42
  start-page: 3227
  issue: 34
  year: 2021
  ident: pmed.1004556.ref003
  article-title: 2021 ESC guidelines on cardiovascular disease prevention in clinical practice
  publication-title: Eur Heart J
  doi: 10.1093/eurheartj/ehab484
– volume: 37
  start-page: 1129
  issue: 8
  year: 2021
  ident: pmed.1004556.ref004
  article-title: 2021 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in adults
  publication-title: Can J Cardiol
– volume: 201974
  issue: 10
  year: 2019
  ident: pmed.1004556.ref005
  article-title: ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the american college of cardiology/american heart association task force on clinical practice guidelines
  publication-title: J Am Coll Cardiol
– volume: 30
  start-page: 1856
  issue: 17
  year: 2023
  ident: pmed.1004556.ref031
  article-title: Comparison of the European and US guidelines for lipid-lowering therapy in primary prevention of cardiovascular disease
  publication-title: Eur J Prev Cardiol
  doi: 10.1093/eurjpc/zwad193
– volume: 328
  start-page: 746
  issue: 8
  year: 2022
  ident: pmed.1004556.ref002
  article-title: Statin use for the primary prevention of cardiovascular disease in adults: US preventive services task force recommendation statement
  publication-title: JAMA
  doi: 10.1001/jama.2022.13044
– volume: 7
  start-page: 785
  issue: 8
  year: 2022
  ident: pmed.1004556.ref006
  article-title: Time to revisit using 10-year risk to guide statin therapy
  publication-title: JAMA Cardiol
  doi: 10.1001/jamacardio.2022.1883
– volume: 18
  issue: 3
  year: 2021
  ident: pmed.1004556.ref013
  article-title: Applicability and cost-effectiveness of the Systolic Blood Pressure Intervention Trial (SPRINT) in the Chinese population: a cost-effectiveness modeling study
  publication-title: PLoS Med
– volume: 3
  start-page: 1090
  issue: 11
  year: 2018
  ident: pmed.1004556.ref028
  article-title: A long-term benefit approach vs standard risk-based approaches for statin eligibility in primary prevention
  publication-title: JAMA Cardiol
  doi: 10.1001/jamacardio.2018.3476
– volume: 43
  start-page: 61
  issue: 1
  year: 2014
  ident: pmed.1004556.ref012
  article-title: Cohort profile: The China Health and Retirement Longitudinal Study (CHARLS)
  publication-title: Int J Epidemiol
  doi: 10.1093/ije/dys203
– volume: 388
  issue: 10062
  year: 2016
  ident: pmed.1004556.ref022
  article-title: Guidelines for accurate and transparent health estimates reporting: the GATHER statement
  publication-title: Lancet
  doi: 10.1016/S0140-6736(16)30388-9
– volume: 4
  start-page: 969
  issue: 10
  year: 2019
  ident: pmed.1004556.ref032
  article-title: Cost-effectiveness of low-density lipoprotein cholesterol level-guided statin treatment in patients with borderline cardiovascular risk
  publication-title: JAMA Cardiol
  doi: 10.1001/jamacardio.2019.2851
– volume: 6
  issue: 2
  year: 2017
  ident: pmed.1004556.ref019
  article-title: Population impact & efficiency of benefit-targeted versus risk-targeted statin prescribing for primary prevention of cardiovascular disease
  publication-title: J Am Heart Assoc
  doi: 10.1161/JAHA.116.004316
– volume: 121
  start-page: 1315
  issue: 11
  year: 2018
  ident: pmed.1004556.ref025
  article-title: Statin eligibility in primary prevention: from a risk-based strategy to a personalized approach based on the predicted benefit
  publication-title: Am J Cardiol
  doi: 10.1016/j.amjcard.2018.02.011
– volume: 41
  start-page: 348
  issue: 2
  year: 2015
  ident: pmed.1004556.ref023
  article-title: Multiple imputation: a mature approach to dealing with missing data
  publication-title: Intensive Care Med
  doi: 10.1007/s00134-014-3624-x
– volume: 6
  start-page: 1406
  issue: 12
  year: 2021
  ident: pmed.1004556.ref026
  article-title: Association between cumulative low-density lipoprotein cholesterol exposure during young adulthood and middle age and risk of cardiovascular events
  publication-title: JAMA Cardiol
  doi: 10.1001/jamacardio.2021.3508
– volume: 7
  issue: 10
  year: 2019
  ident: pmed.1004556.ref015
  article-title: World health organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions
  publication-title: Lancet Glob Health
– volume: 35
  start-page: 837
  issue: 13
  year: 2014
  ident: pmed.1004556.ref020
  article-title: Personalized cardiovascular disease prevention by applying individualized prediction of treatment effects
  publication-title: Eur Heart J
  doi: 10.1093/eurheartj/ehu004
– volume: 388
  start-page: 2532
  issue: 10059
  year: 2016
  ident: pmed.1004556.ref035
  article-title: Interpretation of the evidence for the efficacy and safety of statin therapy
  publication-title: Lancet
  doi: 10.1016/S0140-6736(16)31357-5
– volume: 15
  issue: 3
  year: 2018
  ident: pmed.1004556.ref007
  article-title: Primary prevention of cardiovascular disease: the past, present, and future of blood pressure- and cholesterol-lowering treatments
  publication-title: PLoS Med
– volume: 8
  start-page: 100096
  year: 2021
  ident: pmed.1004556.ref016
  article-title: Validating world health organization cardiovascular disease risk charts and optimizing risk assessment in China
  publication-title: Lancet Reg Health West Pac
– volume: 395
  start-page: 795
  issue: 10226
  year: 2020
  ident: pmed.1004556.ref009
  article-title: Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study
  publication-title: Lancet
  doi: 10.1016/S0140-6736(19)32008-2
– volume: 2
  start-page: 102
  issue: 2
  year: 2016
  ident: pmed.1004556.ref017
  article-title: Risk stratification of atherosclerotic cardiovascular disease in Chinese adults
  publication-title: Chronic Dis Transl Med
– volume: 188
  start-page: 1871
  issue: 11
  year: 2019
  ident: pmed.1004556.ref014
  article-title: Venous blood-based biomarkers in the China health and retirement longitudinal study: rationale, design, and results from the 2015 wave
  publication-title: Am J Epidemiol
  doi: 10.1093/aje/kwz170
– volume: 3
  start-page: 100825
  issue: 3
  year: 2024
  ident: pmed.1004556.ref011
  article-title: The causal-benefit model to prevent cardiovascular events
  publication-title: JACC Adv
  doi: 10.1016/j.jacadv.2023.100825
– volume: 381
  start-page: 1028
  year: 2023
  ident: pmed.1004556.ref001
  article-title: Cardiovascular disease risk assessment and reduction: summary of updated NICE guidance
  publication-title: BMJ
– volume: 43
  start-page: 2852
  issue: 30
  year: 2022
  ident: pmed.1004556.ref008
  article-title: Modifiable risk factors associated with cardiovascular disease and mortality in China: a PURE substudy
  publication-title: Eur Heart J
  doi: 10.1093/eurheartj/ehac268
– volume: 145
  start-page: 1312
  issue: 17
  year: 2022
  ident: pmed.1004556.ref024
  article-title: Beyond 10-year risk: a cost-effectiveness analysis of statins for the primary prevention of cardiovascular disease
  publication-title: Circulation
  doi: 10.1161/CIRCULATIONAHA.121.057631
– volume: 350
  year: 2015
  ident: pmed.1004556.ref021
  article-title: Statistics notes: bootstrap resampling methods
  publication-title: BMJ
  doi: 10.1136/bmj.h2622
– volume: 45
  start-page: 117
  issue: 2
  year: 2024
  ident: pmed.1004556.ref030
  article-title: Recommendations for statin management in primary prevention: disparities among international risk scores
  publication-title: Eur Heart J
  doi: 10.1093/eurheartj/ehad539
– volume: 133
  start-page: 1574
  issue: 16
  year: 2016
  ident: pmed.1004556.ref010
  article-title: Individualized statin benefit for determining statin eligibility in the primary prevention of cardiovascular disease
  publication-title: Circulation
  doi: 10.1161/CIRCULATIONAHA.115.018383
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Snippet Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this...
Background Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores....
BackgroundCurrent guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores....
Qiuping Liu and her colleagues compare the conventional, absolute, risk-based approach with an individualized, benefit-based approach that considers the...
Background Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores....
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SubjectTerms Adult
Aged
Aged, 80 and over
Analysis and chemistry
Biology and Life Sciences
Blood
Cardiovascular agents
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - blood
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
China - epidemiology
Cholesterol
Cholesterol, LDL - blood
Decision making
Diabetes
Diabetes mellitus
Discordance
Disease prevention
Dosage and administration
East Asian People
Efficiency
Female
Health aspects
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Lipids
Lipoproteins
Longitudinal Studies
Low density lipoprotein
Male
Medicine and Health Sciences
Middle Aged
Population
Population studies
Prevention
Primary Prevention - methods
Review boards
Risk Assessment
Risk factors
Statins
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Title Absolute risk-based versus individualized benefit approaches for determining statin eligibility in primary prevention of cardiovascular diseases in Chinese populations: A modeling study
URI https://www.ncbi.nlm.nih.gov/pubmed/40694580
https://www.proquest.com/docview/3270865618
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https://pubmed.ncbi.nlm.nih.gov/PMC12282892
https://doaj.org/article/36b3bcd753454086bf3d911da62ca482
http://dx.doi.org/10.1371/journal.pmed.1004556
Volume 22
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