動脈硬化性疾患予防ガイドライン2022年版

Q: What are the key findings of this study?

The 2022 Japan Atherosclerosis Society guidelines update lipid management by adopting the Hisayama risk score to predict the absolute risk of coronary heart disease and atherothrombotic brain infarction.

Q: What is the clinical evidence from this study?

Study design: Review. Population: Atherosclerotic Cardiovascular Disease and Dyslipidemia. Intervention: JAS Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022.

Tomonori Okamura

doi:10.2169/naika.114.1949

October 10, 2025Nihon Naika Gakkai ZasshiOpen Access

動脈硬化性疾患予防ガイドライン2022年版

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Key Points

To outline the core revisions in the Japan Atherosclerosis Society 2022 Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases, focusing on risk assessment and lipid-lowering targets.
Incorporated atherothrombotic brain infarction alongside coronary artery disease into absolute risk assessment for primary prevention.
Adopted a modified Hisayama Study risk prediction model utilizing sex, systolic blood pressure, glucose metabolism status, LDL-C, HDL-C, and current smoking across 10-year age groups.
Stratified lipid control targets based on primary prevention risk tiers (low, moderate, high risk) and secondary prevention categories.
In primary prevention, target LDL-C levels are set at <160 mg/dL for low risk, <140 mg/dL for moderate risk, <120 mg/dL for high risk, and <100 mg/dL for high-risk diabetes with microangiopathy.
In secondary prevention, standard LDL-C targets are <100 mg/dL, with a stricter target of <70 mg/dL for patients with acute coronary syndrome, familial hypercholesterolemia, diabetes, or combined coronary and atherothrombotic stroke.
First-line pharmacological therapy remains statins, with ezetimibe or PCSK9 inhibitors recommended as combination therapy if LDL-C goals are unmet.

Structured PICO

P

Population

Japanese adults targeted for primary and secondary prevention of atherosclerotic cardiovascular diseases

I

Intervention

Guideline-directed lipid management and lifestyle modification based on absolute risk assessment using the Hisayama score (predicting coronary artery disease and atherothrombotic stroke)

Limitations

Lifetime risk evaluation for the Japanese population is not yet incorporated into the current guidelines due to ongoing evidence accumulation.
Lifetime risk estimation is not yet introduced in the guidelines but remains a future challenge for younger populations.

Implication

The Japan Atherosclerosis Society 2022 guidelines update risk assessment by integrating atherothrombotic stroke with coronary artery disease and establish strict, risk-stratified LDL-C targets for primary and secondary prevention.

Abstract

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Discussion

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Cite This Study

Tomonori Okamura (2025) conducted a review in Atherosclerotic Cardiovascular Disease and Dyslipidemia. JAS Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022 was evaluated. The 2022 Japan Atherosclerosis Society guidelines update lipid management by adopting the Hisayama risk score to predict the absolute risk of coronary heart disease and atherothrombotic brain infarction.

synapsesocial.com/papers/6acb127622e5745bb069e255 https://doi.org/10.2169/naika.114.1949

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動脈硬化性疾患予防ガイドライン2022年版

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

動脈硬化性疾患予防ガイドライン2022年版

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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