[How transparent is the new Dutch guideline on cardiovascular risk management?]

Abstract

The new Dutch guideline on cardiovascular risk management has lowered the target value for LDL cholesterol from 2.5 to 1.8 mmol/L. The authors claim transparency, yet there is no hard scientific evidence that supports this new target value. There is only a theoretical model developed by theCholesterol Treatment Trialists' (CTT) Collaboration Group. This group has the raw data of the cholesterol trials and they have signed confidentiality agreements with manufacturers stating that they will not share this data with others. This group also produced the Cochrane review on primary cardiovascular prevention with statins. If the real effect of cholesterol-lowering drugs is not disclosed to the population in a transparent manner, this will be done through independent channels with the message 'leave those PCSK9 inhibitors alone until there is hard scientific evidence for their efficacy.' And if patients suffer greatly from, for example,muscle pain, diabetes or amnesia due to taking statins, in accordance with the guideline they will decide for themselves whether or not to continue taking it.