An Overview of the Guideline Development Process for Atherosclerotic Cardiovascular Disease Risk Reduction with an Emphasis on Guidelines for Cholesterol and Dyslipidemia Management

Clinical practice guidelines for lipid management of atherosclerotic cardiovascular disease (ASCVD) are to be used in combination with clinical judgement to improve patient care and cardiovascular outcomes. In the United States, ASCVD risk prevention and cholesterol management guidelines have evolved from those in the National Heart, Lung, and Blood Institute-sponsored Adult Treatment Panels I–III to those put forth by the American College of Cardiology (ACC) and American Heart Association (AHA), with sponsorship by multiple stakeholder organizations. The classification system adopted for the ACC/AHA recommendations utilizes a class of recommendation designation to signify the magnitude of benefit over risk for each recommendation and a quality of evidence rating to acknowledge the types of studies and supporting data on which the recommendation is based. A “knowledge chunk” format is used to present recommendations; this includes a table of the recommendations, synopsis, supporting text, and flow diagrams or additional tables for each “chunk” of information. The process of guideline development depends on the philosophy and instructional approach that is most representative of the sponsoring organization and is an integration of the scientific underpinning of the data supporting the recommendations and of the perceived optimal methods for maximizing clinician utilization.