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. 2017 Dec 18;178(3):414–416. doi: 10.1001/jamainternmed.2017.7198

Figure. Variation in the Share of Intensification vs Deintensification Recommendations.

Figure.

Guidelines for cardiovascular disease management included ischemic heart disease, hypertension, hyperlipidemia, heart failure, atrial fibrillation, acute coronary syndrome, myocardial infarction, and cognitive or mental health sequelae. The evidence strength of the recommendations was based on the evidence ratings provided by the guideline developers. Recommendations were drawn from the following guidelines (N = 22 total guidelines). American Diabetes Association (n = 1): Standards of Medical Care in Diabetes—2016 (2016). Eighth Joint National Committee (n = 1): Management of High Blood Pressure in Adults. American Geriatrics Society (n = 1): Improving the Care of Older Adults With Diabetes Mellitus: 2013 Update (2013). Veterans Health Administration (n = 2): Diagnosis and Management of Hypertension in the Primary Care Setting (2014); Management of Dyslipidemia for Cardiovascular Risk Reduction (2014). US Preventive Services Task Force (n = 6): Screening for Coronary Heart Disease With Electrocardiography (2012); Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer (2014); Screening for High Blood Pressure in Adults (2015); Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus (2015); Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer (2015; draft); Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication (2015; draft). American College of Cardiologists/American Heart Association (n = 9): Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease (2011); Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women (2011); Diagnosis and Management of Patients With Stable Ischemic Heart Disease (2012; jointly issued with the American College of Physicians); Assessment of Cardiovascular Risk (2013); Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults (2013); Management of Heart Failure (2013); Management of Patients With Atrial Fibrillation (2014); Management of Adult Patients With Supraventricular Tachycardia (2015; only for the recommendations related to atrial fibrillation); Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease (2016). American College of Physicians (n = 3): Diagnosis and Management of Patients With Stable Ischemic Heart Disease (2012; jointly issued with the American College of Cardiologists/American Heart Association); Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus (2012); Cardiac Screening With Electrocardiography, Stress Echocardiography, or Myocardial Perfusion Imaging (2015).