The implications of new cholesterol guidelines on a rural Midwest community
At the 2014 American Heart Association Scientific Sessions in Chicago, Ill., Minneapolis Heart Institute Foundation Research Cardiologist Dr. Michael Miedema gave a presentation entitled "The Implications of the Recent American College of Cardiology/American Heart Association Guidelines for the Treatment of Blood Cholesterol on a Rural Community: The Heart of New Ulm Project."
"The recently released cholesterol guidelines appear to have significantly increased the number of middle-aged adults who qualify for a cholesterol-lowering statin," stated Miedema. "We wanted to evaluate what the impact of the guidelines will be on a rural community because these populations are rarely included in traditional research cohorts."
In the study, Dr. Miedema and his colleagues analyzed the electronic health data from 4,281 residents of New Ulm, Minn. The study subjects were between the ages of 40 and 79, with a mean age of 59.4 years, and 52.7 percent of the subjects were female. The data studied was from health care visits that occurred during 2012 - 2013, before the release of the new ACC/AHA cholesterol guidelines. The new guideline criteria were applied to the sample to determine the potential impact of implementation of the guidelines.
Dr. Miedema found that, under the new guidelines, 59 percent of the study subjects met one of the four major indications for statin therapy. But of that number, only 65 percent were on a statin at the time of the assessment. Additionally, only 11% were taking a high-intensity statin. The new guidelines recommend routine use of "high-intensity" statins. Full doses of atorvastatin and rosuvastatin are considered high-intensity statins.
The new guidelines especially increase qualification for statin therapy in older individuals, with researchers finding that 86% of individuals over age 60 qualified for statin therapy. "Our results confirm that, in a rural population, the new cholesterol guidelines substantially increase the number of individuals who qualify for a statin. The biggest driver of this increase is that a substantially larger number of older individuals without known heart disease qualify for a statin under the new guidelines, and that's a controversial area. We definitely need more research aimed at figuring out the best methods to determine who should and should not take a statin," concluded Miedema.
The annual American Heart Association Scientific Sessions is the leading cardiovascular conference for basic, translational, clinical and population science with more than 15,000 cardiovascular health experts in attendance. The 2014 sessions are being held at McCormick Place in Chicago, Ill.