p.6 抽出テキスト
CLINICAL STATEMENTS AND GUIDELINES Circulation. 2025;152:e114–e218. DOI: 10.1161/CIR.0000000000001356 September 16, 2025 e119 PREAMBLE Since 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translated scientific evidence into clinical practice guidelines with recommendations to improve cardiovascular health. These guidelines, which are based on systematic meth ods to evaluate and classify evidence, provide a founda tion for the delivery of quality cardiovascular care. The ACC and AHA sponsor the development and publication of clinical practice guidelines without commercial sup port, and members volunteer their time to the writing and review efforts. Guidelines are the official policy of the ACC and AHA. For some guidelines, the ACC and AHA collaborate with other organizations. Intended Use Clinical practice guidelines provide recommendations applicable to patients with or at risk of developing cardio vascular disease (CVD). The focus is on medical practice in the United States, but these guidelines are relevant to patients throughout the world. Although guidelines may be used to inform regulatory or payer decisions, the in tent is to improve quality of care and align with patients’ interests. Guidelines are intended to define practices meeting the needs of patients in most, but not all, cir cumstances and should not replace clinical judgment. Clinical Implementation Management in accordance with guideline recommenda tions is effective only when followed by both practitioners and patients. Adherence to recommendations can be en hanced by shared decision-making between clinicians and patients, with patient engagement in selecting inter ventions based on individual values, preferences, associ ated conditions, and comorbidities. Methodology and Modernization The ACC/AHA Joint Committee on Clinical Practice Guide lines (Joint Committee) continuously reviews, updates, and modifies guideline methodology on the basis of published standards from organizations, including the National Acad emy of Medicine (formerly the Institute of Medicine),1,2 and on the basis of internal reevaluation. Similarly, presentation and delivery of guidelines are reevaluated and modified in response to evolving technologies and other factors to op timally facilitate dissemination of information to health care professionals at the point of care. Numerous modifications to the guidelines have been implemented to make them shorter and enhance “user friendliness.” Guidelines are written and presented in a modular recommendation format in which each chunk includes a table of recommendations, a brief synopsis, recommendation-specific supportive text and, when appropriate, flow diagrams or additional tables. Hyper linked references are provided for each modular knowl edge chunk to facilitate quick access and review. In recognition of the importance of cost-value con siderations, in certain guidelines, when appropriate and feasible, an assessment of value for a drug, device, or intervention may be performed in accordance with the AHA/ACC methodology.3 To ensure that guideline recommendations remain cur rent, new data will be reviewed on an ongoing basis by the writing committee and staff. When applicable, recom mendations will be updated with new evidence, or new recommendations will be created when supported by published evidence-based data. Going forward, targeted sections/knowledge chunks will be revised dynamically after publication and timely peer review of potentially practice-changing science. The previous designations of “full revision” and “focused update” will be phased out. For additional information and policies on guideline develop ment, readers may consult the AHA/ACC guideline meth odology manual4 and other methodology articles.5–7 Selection of Writing Committee Members The Joint Committee strives to ensure that the guide line writing committee contains requisite content exper tise and is representative of the broader cardiovascular community by selection of experts across a spectrum of backgrounds, representing different geographic regions, sexes, races, ethnicities, intellectual perspectives/biases, and clinical practice settings. Organizations and profes sional societies with related interests and expertise are invited to participate as collaborators. Relationships With Industry and Other Entities The ACC and AHA have rigorous policies and methods to ensure that documents are developed without bias or improper influence. The complete policy on relationships with industry and other entities (RWI) can be found on line. Appendix 1 of the guideline lists writing committee members’ comprehensive and relevant RWI. Evidence Review and Evidence Review Committees In developing recommendations, the writing committee uses evidence-based methodologies that are based on all available data.4,5 Literature searches focus on ran domized controlled trials (RCTs) but also include reg istries, nonrandomized comparative and descriptive studies, case series, cohort studies, systematic reviews, and expert opinion. Only key references are cited. An independent evidence review committee is com missioned when there are ≥1 questions deemed of Downloaded from http://ahajournals.org by on October 7, 2026