The 2013 Guideline Shift

Panelists discuss how the 2013 American College of Cardiology and the American Heart Association cholesterol guideline shift—removing low-density lipoprotein cholesterol (LDL-C)–target goals—profoundly altered frontline practice. The focus transitioned from achieving specific LDL numbers to prescribing statins based on risk categories.

While intended to simplify care, this change reduced motivation to monitor LDL levels and weakened accountability for outcomes. Many clinicians deprioritized follow-up lipid testing, leading to gaps in disease management.

Panelists suggest that this shift, though evidence-based at the time, inadvertently diluted LDL-C control efforts and contributed to widespread undertreatment.