More Americans Should Be Taking Statins
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Brett Smith for redOrbit.com – Your Universe Online
Cholesterol-lowering drugs should be prescribed to about 33 million more Americans, according to new guidelines for healthcare providers recently released by a joint committee from the American Heart Association and American College of Cardiology.
The new guidelines said those without cardiovascular disease, but who have a 7.5 percent or higher risk for a heart attack or stroke within the next 10 years would benefit from taking statins, a group of seven cholesterol-lowering drugs.
“We’ve been undertreating people who need statin therapy in this country,” said Dr. Donald Lloyd-Jones, one of 20 authors of the new guidelines.
The new guidelines are a significant change from the existing recommendations released in 2002, which said patients should only be prescribed a statin if their 10-year risk level was above 20 percent. While the old guidelines only included risk for heart disease, the new recommendations now consider a patient’s risk for stroke.
“Statins lower cholesterol levels, but what they really target is overall cardiovascular risk,” said Lloyd-Jones, a cardiologist at Northwestern University in Chicago.
“These new guidelines represent the best of what scientific research can tell us about how to prevent heart disease and stroke,” said Dr. Mariell Jessup, president of the American Heart Association and medical director at the University of Pennsylvania in Philadelphia. “These recommendations will help guide the clinical decisions doctors make every day to protect their patients from two of the nation’s biggest killers.”
The new guidelines also take a different, more comprehensive approach to treating obesity. The recommendations involve a three-pronged approach: eating fewer calories, exercising more and changing unhealthy habits.
According to Dr. Frank Hu, a professor of epidemiology at Harvard School and co-author of the new guidelines, doctors also need to be more active in helping their patients achieve and maintain a healthy body weight.
“Clinicians should not just think of obesity as a lifestyle issue. They should treat obesity as a disease,” Hu said. “Providing preventive care services such as obesity screening and behavioral counseling are critically important.”
The new guidelines include a “roadmap” to help patients shed weight and maintain a healthy physique. The roadmap begins with determining every American’s body mass index (BMI) on a yearly basis. Patients with a BMI of 30 or greater are considered obese and in need of treatment – which describe about 78 million Americans, according to the American Heart Association.
“The key message here is that we know weight loss isn’t just about will power,” said Dr. Donna Ryan, co-chair of the committee that wrote the guideline and professor of biomedical research at Louisiana State University. “It’s about behaviors around food and physical activity, and getting the help you need to change those behaviors.”
The new guidelines also provide updated equations for predicting the risk of heart attack or stroke in African-Americans, who tend to be at higher risk for these events than whites. Healthcare providers had, for decades, relied on risk equations based on research of a white population. Doctors also often used equations to determine the risk for heart disease and stroke risk separately.
“We believe the new equations are better because they are based on a broader, more current set of research data and assess both heart attack and stroke risk,” said David Goff, dean of the Colorado School of Public Health.