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New cholesterol guidelines | Dr. Petter
New guidelines for taking cholesterol-lowering medication were recently released by the American Heart Association (AHA), in conjunction with the American College of Cardiology (ACC).
These new guidelines bring prescribing recommendations into the 21 century. They modify a recommendation that centered on the Framingham Heart study (dating back to 1948).
What are the new guidelines?
They are recommendations for assessing, measuring and treating cholesterol levels with a statin medication (i.e., lovastatin, simvastatin, pravochol). Now risk factors are directly factored into the decision (calculation) to begin this type of medication.
Risk factors like high blood pressure, weight, age, smoking, family history of heart disease and the diagnosis of diabetes become significant.
Certainly, if an individual already has heart disease or diabetes, they should already be on a statin. Rather, these new guidelines focus on decreasing the development of heart disease in healthy individuals, especially those ages 40 to 75, whose cholesterol values may be normal. Using a table established by the AHA and ACC, if your 10-year risk assessment is 7.5 percent or higher, statin treatment should be considered.
Criticism over these new guidelines are valid, as statins should not be prescribed for everyone. Clinical judgment, along with a review of individual risks, should be reviewed by your doctor.
Certainly lifestyle changes are still important as a first step: blood pressure, weight control, healthy diet and regular exercise. However, if your calculated 10-year risk assessment is 7.5 percent or higher, a strong consideration to begin statin therapy should be considered.
A major concern is that these new recommendations will overestimate people needing prescription treatment, putting more than 31 million people on medication. However, we have a major health epidemic in this country. At this time, one in three adults will die of a heart attack, and heart disease is the leading cause of death in the United States.
If lifestyle changes are not effective in a reasonable period of time to lower a personal calculated risk, statin treatment should strongly be considered to potentially avoid a shortened life expectancy.
Prevention is really the focus and pure intention of these new prescribing guidelines, not making pharmaceutical companies more wealthy. The decision to begin statin therapy should be done on a case-by-case basis, as these are just recommendations, not rules.
The decision to take a statin medication is truly an individual investment, both financially and physically, with no absolute guarantee of long-term outcome and results.
Dr. Linda Petter of Auburn is a weekly feature on KOMO TV/Newsradio (1000 AM & 97.7 FM) every Saturday and Sunday at 7:45 a.m. and 9:45 a.m. She trained at the Mayo Clinic and the University of Illinois, Carle Hospital. Dr. Petter is chief of the Department of Family Practice at St. Francis Hospital in Federal Way. She is a consumer healthcare advocate and author of two books ("Healthcare On a Budget" and "Common Medical Sense"). Visit her website, www.DocForAll.com, or call her office at 253-568-0841.