New guidelines could put more people on statins

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By Lorna Benson
Minnesota Public Radio

For nearly a decade, many physicians and patients have lived by the mantra of driving down so-called “bad” cholesterol.
But under new guidelines from the American Heart Association and the American College of Cardiologists, a patient’s LDL cholesterol doesn’t matter as much.
Instead doctors are being urged to consider using cholesterol-lowering statins on more of their patients to prevent heart attacks and strokes - a revised treatment plan that likely will place many more Minnesotans on drug therapy.
The two heath associations released the new guidelines after conducting an extensive review of recent medical studies. The findings of that review show that the long-held emphasis on reducing LDL cholesterol wasn’t based on much evidence.
Dr. Randy Thomas, director of the Cardiovascular Health Clinic at Mayo Clinic in Rochester, said the new guidelines are a dramatic shift in thinking.
“It’s going to be a change. It’s going to be an adjustment,” Thomas said. “But I think it’s an advance in a good direction.”
The new guidelines identify four risk groups who can benefit from taking statins. They vary by age and include people who have a very high level of bad cholesterol or a history of cardiovascular problems or diabetes. They also include people who don’t have any signs of cardiovascular disease, but who have at least a 7.5 percent risk for having a heart attack or stroke within 10 years.
Under the old guidelines, many people with only moderate disease risk were not offered statins. Those patients were undertreated, said Dr. Jay Cohn, director of the Rasmussen Center for Cardiovascular Disease Prevention at the University of Minnesota.
“I hope it means that more people will take a statin drug,” Cohn said of the new recommendation. “But what it really should mean is that the right people should take a statin drug; those who don’t need it shouldn’t be taking it and those who do, should. And we’ve done a poor job of that up until now.”
 

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