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Nov 25

New Heart Health Guidelines

heart_stethoscopeAfter decades of cajoling Americans to know their cholesterol level and get it down as low as possible, the nation’s leading heart specialists are changing course.

Cholesterol is still important. But new guidelines published recently throw out the notion that a specific blood cholesterol level should automatically trigger treatment with cholesterol-lowering drugs.

Also out the window is any notion of treating patients with drugs until their so-called bad cholesterol hits a specific target – one that for most people is all but impossible to achieve by diet alone.

Instead, the new guidelines groups adults into four categories most likely to benefit from cholesterol-lowering drugs. They include people with heart disease and diabetes, as well as people with high levels of LDL cholesterol, the bad kind.

The guidelines also explicitly tell doctors not to bother with drugs other than statins, saying they’re the only ones proven to reduce the risk of heart attacks and strokes.

The effect of the new guidelines would be to double the number of Americans who are candidates for lifelong statin therapy, according to Dr. Sidney Smith of the University of North Carolina, one of the guideline writers.

Nobody knows for sure how many Americans are already taking statin drugs. Under the old guidelines, 15 percent of adults are recommended for treatment, or about 15 million people. A doubling of that would be 30 million. But by some estimates, the number currently taking statins may already approach that number.

“It may be there are a substantial number of patients now on statin therapy where there is not strong evidence of benefit,” Smith tells Shots. “The new guidelines will treat better and smarter, focusing on populations most likely to benefit.”

Statin drugs marketed in the United States include brand names such as Crestor, and generic versions of Lipitor and Zocor. They cost from $4 to $150 per month.

The new guidelines were developed jointly by the American College of Cardiology and the American Heart Association, at the behest of the National Heart, Lung and Blood Institute, a federal agency. They are based on the most up-to-date research on prevention of heart attacks and strokes.

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