2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia, engl.

Year of publication: 2026

Classification: -

Registration number: ACC-20260608

Editing medical society(ies):

Other medical societies involved: 10

AWMF detail view


List of evaluated guidelines

Evaluation by Leitlinienwatch

11.06.26


PTs.

Criterion
3

Transparency

The American College of Cardiology, ACC, and the American Heart Association, AHA, have Conflicts of interests (COI) regulations (https://www.acc.org/Guidelines/About-Guidelines-and-Clinical-Documents). Appendix 1 of the guideline (https://www.ahajournals.org/doi/epdf/10.1161/CIR.0000000000001423) lists the COI (here called "RWI" "relationships with industry and other entities") for the authors, Appendix 2 contains the COI declaration for the peer reviewers. The specific regulations are defined in a sub-document (https://www.acc.org/-/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/About-Guidelines-and-Clinical-Documents/)AHA_ACC_Disclosure_RWI_Policy.pdf) linked therein. Thus, the AHA and ACC Senior Staff Leadership has the responsibility to assess the reported relationships and decide whether they are classified as relevant (RWI) (§ 2.1.5 – Relevance to the document). The Joint Committees (Joint Committee on Clinical Practice Guidelines JCCPG and Joint Committee on Performance Measures JCPM) monitor the composition of the writing committees and review the collected RWI data.
0

Composition of the Guideline Working Group

The ACC-RWI regulations state: "The Chair and at least half the writing committee members must be free of relevant RWI", yet 28/33 (85%) of the authors have documented COI/RWI. Of these, 8 (24%) authors classified their RWI as "not relevant" despite RWI concerning a product relevant to the guideline, while 7 (21%) authors described their COI/RWI as relevant. 17/33 (52%) authors worked as consultants, of which 9/33 (27%) worked in areas relevant to the guideline. In principle, the professional societies do not exclude reviewers with COI/RWI. In the current reviewer group, 21/29 (72%) people had relevant institute-related and 7/29 (245) also personal COI/RWI: 21/29. 12/29 (41%) reviewers worked as consultants.
3

Independence of the Coordinators/Chairs/Lead AuthorsUnabhängigkeit der Vorsitzenden/federführenden Autoren

The ACC-RWI regulations stipulate: "The Chair or Co-Chairs of writing committees must not have relevant RWI in the timeframes defined above". Both leaders state that they do not have COI/RWI.
1

Abstention from Voting

Although experts with relevant relationships can contribute to discussions, the above guidelines prohibit them from voting on final recommendations to maintain objectivity. In the section "2.1.4. Financial Value or Level of Relationship", a 5% limit measured by annual income is also defined as relevant for financial relationships, e.g. with the pharmaceutical industry. However, there are no concretely documented voting results or abstentions in the guideline (which would be relevant, since depending on the definition, about 1/4 to half of the authors have relevant COI/RWI).
0

External Review of the Guideline

A review of the draft guideline via a publicly accessible website did not take place.
2

Bonus Points

Systematic literature and evidence sourcing, multi-stage peer review process.

Explanations to the evaluation criteria

Overall score

9

Good! (11-18)

Warning! (6-10)

Needs reform! (0-5)

Comment

This guideline from the two U.S. cardiology societies is an update of the 2018 guideline. The AHA/ACC conflict of interest regulations of the professional societies used here actually provide a structured approach to conflicts of interest. As with many other guideline providers (e.g. ESC and sometimes AWMF), the central problem is the assessment of the degree of conflicts of interest. For example, the documented self-classification of 24% of the authors is very doubtful, as they described COI/RWI on companies that produce cholesterol-lowering drugs as irrelevant. Against this background in particular, the lack of traceability and documentation of the voting behaviour is problematic, especially since authors with relevant RWI/COI were not excluded from the discussion of the topics affecting them.
Conclusion: This internationally highly relevant guideline once again uncritically adopts the "the lower-the better" cholesterol dogma analogous to the ESC guidelines. If this guideline were to be consistently implemented, millions of Americans would be stamped as sick and would have to take several medications for the rest of their lives - although the data on this is poor. It is again noticeable that higher-quality guidelines (such as the corresponding AWMF-S3 guidelines) with less conflict-prone guideline groups come to discrepant results.

Note: This evaluation was conducted with due care on the basis of the published guideline. Should you still discover an error, please contact us at info@leitlinienwatch.de.