Applying new cholesterol guidelines to a patient population reduces heart attacks, strokes, study finds

August 18, 2014
Applying new cholesterol guidelines to a patient population reduces heart attacks, strokes, study finds
Dr. Amit Khera. Credit: UT Southwestern

A study from UT Southwestern researchers found that recently introduced cholesterol guidelines would significantly reduce new cardiovascular events, when compared to treatment based on previous cholesterol guidelines.

The research identified Dallas Heart Study participants in the 30 to 65 age range who would have newly qualified for use under the new cholesterol guidelines introduced in 2013 by the American College of Cardiology (ACC) and the American Heart Association (AHA).

In this subset of , the study predicted that 3.6 to 4.9 would have been prevented for every 1,000 people screened and treated according to the new guidelines rather than the old guidelines (using a risk-reduction factor of 30 percent to 45 percent, depending on the statin dosage). The Dallas Heart Study is a multiethnic, population-based study of thousands of Dallas County adults whose cardiovascular health has been followed for 10 years.

Projecting these findings onto the larger Dallas County population, about 4,500 serious heart problems would have been prevented in individuals 30 to 65 years of age over a 10-year period by following the new cholesterol guidelines.

When the new guidelines were introduced – replacing previous guidelines from the National Cholesterol Education Program/Third Adult Treatment Panel – they provoked heated debate over the sizeable increase in statin eligibility. However, the UT Southwestern study supports the merit of the new cholesterol guidelines, as well as increased statin use.

 "This is one of the first studies to carefully predict the implications of the new guidelines in the general population beyond just the amount of increase in statin use," said Dr. Amit Khera, Associate Professor of Internal Medicine and Director of the Preventive Cardiology Program at UT Southwestern. "Does it look like these new guidelines will prevent heart attacks and strokes? The answer is, 'yes,'" he said.

Dr. Khera is senior author of the recently published study, which appeared in Circulation: Cardiovascular Quality and Outcomes.

The 2013 ACC/AHA Cholesterol Guidelines recommend statins for patients with existing atherosclerotic cardiovascular disease, type 2 diabetes, and very high levels of LDL cholesterol, as well as for patients with a high 10-year risk for disease.

The previous guidelines from the National Cholesterol Education Program/Third Adult Treatment Panel were based on a different formula that involved targeting specific cholesterol levels. Some patients fall out of statin eligibility under the new guidelines, but some 12.8 million more are newly eligible.

Among Dallas Heart Study participants who actually experienced a cardiovascular event, 37.1 percent more of those patients would have been placed on statins if the new guidelines had been in place. Among participants who did not experience a cardiovascular event, only 3.9 percent more patients would have been prescribed statins.

"There has been a lot of emphasis on the increased use of statins and a lot of emphasis on the risk calculator," said Dr. Khera, who holds the Dallas Heart Ball Chair in Hypertension and Heart Disease. "Yes, there is some additional statin use, but according to our results, this use seems appropriate, at least in this age group."

Explore further: Are the new ACC/AHA guidelines for lipids appropriate for people with diabetes?

Related Stories

Are the new ACC/AHA guidelines for lipids appropriate for people with diabetes?

June 14, 2014
New guidelines for the treatment of high cholesterol are not appropriate for people with type 2 diabetes – or are they? Two researchers will debate the topic at a symposium to be held on Tuesday, June 17, at the American ...

Should men at risk for cardiovascular disease receive earlier cholesterol treatment?

July 22, 2014
New guidelines on cholesterol treatment and cardiovascular risk assessment state that men have at least double the risk of dying from atherosclerotic cardiovascular disease or of having a heart attack or stroke as do women ...

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 ...

US, European cholesterol guidelines differ in statin use recommendations

March 29, 2014
Application of U.S. and European cholesterol guidelines to a European population found that proportions of individuals eligible for statins differed substantially, with one U.S. guideline recommending statins for nearly all ...

New guidelines deem 13 million more Americans eligible for statins

March 19, 2014
New guidelines for using statins to treat high cholesterol and prevent cardiovascular disease are projected to result in 12.8 million more U.S. adults taking the drugs, according to a research team led by Duke Medicine scientists.

Questions raised in US over new anti-cholesterol guidelines

November 20, 2013
New recommendations to expand the use of cholesterol-lowering medication to millions of adults to reduce heart attacks and strokes overestimated risks faced by that population, according to a new study.

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

Dr stephenx11
not rated yet Aug 22, 2014
This is yet another example of a study which reveals that there is no causal relationship between cholesterol and heart disease. How many more studies have to be done before everyone accepts the fact that heart disease is a cultural event?

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.