Heart Guidelines Urge Increased Statin Use

Millions more may use statins for heart disease prevention
illustration of ateriosclerosis

By: Steven Nissen, MD

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The American Heart Association and American College of Cardiology’s new guidelines have taken a dramatic turn in their approach to treatment with cholesterol-lowering statin medications.

The guidelines’ recommendations have changed to suggest physicians identify patients at high risk for heart disease and prescribe statins for them to reduce these risks.

The new guidelines call for the additional use of statins, which lower LDL (bad cholesterol), to overall cardiovascular disease prevention.




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Millions more could be on statins

These recommendations may ultimately result in many more people taking statins.

This is good news. While cholesterol levels are important, they should not be the sole factor in determining statin use.

Under these guidelines, too, patients won’t have to worry about getting cholesterol levels down to a target number as long as they take the right dose of their statin medication.

When you have drugs that are this safe and effective, it makes sense to treat more people. It will be difficult to know how many more, and how long the process will take — but millions more Americans may be taking these drugs in the future.

Four at-risk groups who will benefit from statins

The guidelines recommend prescribing statins to Americans who don’t have heart disease but are at 7.5 percent or more higher risk for heart attack or stroke over the next decade. Doctors will be asked to calculate risk using factors that include cholesterol, blood pressure and age.

Another at-risk group will be people with type-2 diabetes. The guidelines make it very clear that everybody with adult-type diabetes, between the ages of 40 and 75, should be on a statin medication.

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The other at-risk groups recommended for statin treatment:

  • People who’ve already had heart attack, stroke or cardiovascular disease.
  • Those with an LDL level of 190 or higher.

The first defense against heart disease

Along with information to help physicians and healthcare providers better identify people who may be at cardiovascular risk, the new guidelines include a section on obesity that stresses individualized plans and changing behaviors.

With or without statins, what is most critical to preventing heart attacks, strokes and other cardiovascular diseases is taking preventive measures. Eat a heart-healthy diet low in saturated fats, trans fats and sodium, exercise regularly and keep your body weight to the normal level.

We have to keep working with all these factors — lifestyle choices, the right medications and treatments and, of course, preventive measures — to slow down cardiovascular disease. These new guidelines provide a course for us to follow.

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