Integrative medicine: New guidelines recommend statins for 30 million Americans

January 31, 2014

Breaking news: One quarter of Americans reading this article should be on a cholesterol-lowering statin medicine per new guidelines put out last month by the American Heart Association and the American College of Cardiology.

You are one of them if you have:

-Known cardiovascular disease, old , stroke or symptoms that indicate clogged arteries (chest pain, leg pain);

-Age 20 to 75 with LDL (low-density lipoprotein) cholesterol above 190;

-Type 1 or 2 diabetes between the ages of 40 to 75;

-And the new recommendation: healthy people with a 7.5 percent 10-year risk of regardless of cholesterol readings.

The updated recommendations estimate that 30 million Americans fall into the above categories and should consider a statin medication to lower their cholesterol.

So should you run out to your doctor to get a prescription? Perhaps, but the new recommendations have their flaws:

-Critics question the use of a 10-year risk of attack or stroke as the measure for determining who should be treated. (Why not a lifetime risk or some other metric?)

-It appears that the calculator used may overestimate the risk due to the data it was based on.

-Without the old goals of target numbers of cholesterol for certain heart risk categories, patients and their doctors may lose motivation to control or follow .

-Old habits are hard to change, and it may be years before cardiologists and primary care doctors are comfortable throwing away prior LDL guidelines for high-risk patients.

-The new guidelines could easily lead to overtreatment.

Overlooked by most recent media reports, and perhaps most important for those who wish to pursue a proactive, holistic lifestyle: The recommendations state that just because the new risk calculator suggests some people would benefit from statins doesn't mean they absolutely have to take them.

Instead, it is intended that the risk calculator should prompt a conversation between doctor and patient about whether there is a need to take statins or undertake other lifestyle changes to lower cholesterol.

Case in point: A 60-year-old African American woman who smokes and has high blood pressure with a low LDL level is recommended to qualify for a statin under the new guidelines, as she is calculated at a 16 percent 10-year risk for developing heart disease.

However, practical wisdom suggests that perhaps she should stop smoking and control her blood pressure first.

It is important to note that the new statin guidelines are only one part of a package of recommendations to reduce the risk of heart attack and stroke that includes moderate exercise and a healthy diet.

In a much less publicized companion article in the Journal Circulation, simultaneous recommendations were made for diet and exercise in patients with high risk of .

For patients with , there is strong research that shows efficacy in changing diet in reducing cholesterol levels. The recommendation is to eat fruits, vegetables, whole grains, low-fat dairy, poultry, fish, legumes, non-tropical vegetable oils and nuts and limit intake of sweets, sugar-sweetened beverages and red meats.

The exercise prescription recommended for high cholesterol includes aerobic physical activity three to four times a week lasting an average of 40 minutes a session, plus some moderate to vigorous physical activity.

So what do we recommend for a healthy holiday season and a vibrant beginning to a new year? Be empowered to take ownership of your health; you have a lot of control over modifying your risk for coronary artery disease.

Eat right - stop the processed and sugary foods - move your body at least four days a week, stop smoking and lose weight.

You may be able to pull yourself out of the ranks of the Americans who need to be on a statin.

To calculate your personal risk of heart disease based on the new guidelines, go to the American Heart Association's website at www.heart.org.

Explore further: Cholesterol guidelines are based on strong, evidence-based science, AHA says

Related Stories

Cholesterol guidelines are based on strong, evidence-based science, AHA says

November 19, 2013
The American Heart Association and American College of Cardiology vigorously defend the recently published risk assessment and cholesterol guidelines despite recent media reports critical of the risk assessment calculator ...

ACC/AHA publish new guideline for management of blood cholesterol

November 12, 2013
The American College of Cardiology and the American Heart Association today released a new clinical practice guideline for the treatment of blood cholesterol in people at high risk for cardiovascular diseases caused by atherosclerosis, ...

US doctors urge wider use of cholesterol drugs

November 13, 2013
US doctors are calling for the wider use of cholesterol-fighting statin drugs to prevent heart attacks and strokes.

New cholesterol guidelines biggest change in more than 25 years

November 26, 2013
(Medical Xpress)—New cholesterol guidelines for identifying adults at risk for heart disease represent the biggest change in such expert advice in more than 25 years, according to Loyola University Health System preventive ...

New therapy to lower sky-high cholesterol

January 30, 2014
University of Rochester Medical Center cardiologists are first in Upstate New York to offer a blood-cleansing therapy for people with extremely high cholesterol, including two-time heart attack survivor Bob Guesno, whose ...

The skinny on fat and cholesterol

November 18, 2013
Last week, the Food and Drug Administration proposed banning transfat—partially hydrogenated oil—from restaurants and grocery shelves because it raises bad cholesterol and lowers good cholesterol, contributing to heart ...

Recommended for you

Biomechanical mapping method aids development of therapies for damaged heart tissue

January 23, 2018
Researchers have developed a new way to capture the detailed biomechanical properties of heart tissue. The high-resolution optical technique fills an important technology gap necessary to develop and test therapies that might ...

Researchers borrow from AIDS playbook to tackle rheumatic heart disease

January 22, 2018
Billions of US taxpayer dollars have been invested in Africa over the past 15 years to improve care for millions suffering from the HIV/AIDS epidemic; yet health systems on the continent continue to struggle. What if the ...

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.