Considering a cholesterol-lowering statin to prevent a heart attack? Deciding who’s a good candidate requires calculating more than a simple cholesterol level.
A government task force says the popular medications will be of most benefit to some people ages 40 to 75 whose risk of cardiovascular disease over the next decade is at least 10 percent. But Monday’s draft guidelines from the U.S. Preventive Services Task Force left some wiggle room, saying certain patients who aren’t at quite as high a risk still might benefit and should weigh the pros and cons for themselves.
“The benefit from statins is going to be the largest in the people who are at the highest risk,” explained Dr. Douglas Owens, a Stanford University professor and task force member.
The recommendations are similar to controversial 2013 guidelines from the American Heart Association and American College of Cardiology.
Calculating Risk
The task force endorsed usage of an online calculator available through the American Heart Association’s web site.
Doctors plug in information about the patient’s age, sex, race and other health conditions in addition to the level of LDL cholesterol, the so-called bad kind. That’s because recent research shows the combination of factors is particularly important — that someone who might not have qualified for statins on the basis of an LDL level alone could benefit if other factors raise their overall risk.
“We recommend that people between 40 and 75 have an assessment of their cardiovascular risk and that’s not just triggered by your cholesterol,” Owens said.
Other Guidelines
The 2013 guidelines from the heart association and college of cardiology recommended that doctors consider statins in people ages 40 to 75 whose 10-year risk is 7.5 percent or higher. Those guidelines were controversial because they made millions more Americans eligible for statins than older recommendations that focused more on cholesterol levels.
While Monday’s task force conclusion was that people at higher risk get more benefit, the two sets of advice are consistent, said American Heart Association spokesman Dr. Donald Lloyd-Jones of Northwestern University.
Monday’s recommendations are open for public comment through January 25.
