Redefining Quality — Implications of Recent Clinical Trials

Simple approaches to patient care are better — except when they are not. Recent clinical studies are leading to a reexamination of the paradigm whereby efforts to prevent vascular disease focus on the achievement of particular levels of risk factors such as low-density lipoprotein (LDL) cholesterol, systolic blood pressure, and glycated hemoglobin. Although these factors and their levels are important determinants of the development and progression of vascular disease, it is increasingly apparent that the specific strategies used to modify them make a critical difference in patient outcomes. This insight has implications for clinical practice, performance measurement, and regulatory requirements. . . .